Healthcare Provider Details

I. General information

NPI: 1508072067
Provider Name (Legal Business Name): METRO TREATMENT OF SOUTH CAROLINA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

377 RUBIN CENTER DR STE 101
FORT MILL SC
29708-7284
US

IV. Provider business mailing address

2500 MAITLAND CENTER PKWY STE 250
MAITLAND FL
32751-4174
US

V. Phone/Fax

Practice location:
  • Phone: 407-351-7080
  • Fax: 407-351-6930
Mailing address:
  • Phone: 407-351-7080
  • Fax: 407-351-6930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number50004494
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State

VIII. Authorized Official

Name: SCOTT CALL
Title or Position: VP, MANAGED CARE
Credential:
Phone: 480-826-3929