Healthcare Provider Details

I. General information

NPI: 1336593979
Provider Name (Legal Business Name): GAFFNEY URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2016
Last Update Date: 09/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 PROFESSIONAL PARK SUITE B
GAFFNEY SC
29340-2319
US

IV. Provider business mailing address

101 PROFESSIONAL PARK
GAFFNEY SC
29340-2319
US

V. Phone/Fax

Practice location:
  • Phone: 864-489-1446
  • Fax: 864-489-4909
Mailing address:
  • Phone: 864-489-1446
  • Fax: 864-489-4909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALFRED RANDALL MOSS
Title or Position: OWNER
Credential: M.D.
Phone: 864-489-1446