Healthcare Provider Details

I. General information

NPI: 1174784276
Provider Name (Legal Business Name): WARP SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2132 CAROLINA PLACE DR
FORT MILL SC
29708-6983
US

IV. Provider business mailing address

817 STOCKBRIDGE DR 210
TEGA CAY SC
29708-7233
US

V. Phone/Fax

Practice location:
  • Phone: 803-548-8760
  • Fax: 413-541-7742
Mailing address:
  • Phone: 803-548-8760
  • Fax: 413-541-7742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. PATRICK JAMES LARIVE
Title or Position: PRESIDENT / CEO
Credential: PH.D.
Phone: 803-548-8760