Healthcare Provider Details

I. General information

NPI: 1548565971
Provider Name (Legal Business Name): CARRING SHEPPARD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2011
Last Update Date: 01/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 RAES CREEK DR
GREENVILLE SC
29609-1989
US

IV. Provider business mailing address

324 RAES CREEK DR
GREENVILLE SC
29609-1989
US

V. Phone/Fax

Practice location:
  • Phone: 864-292-5442
  • Fax:
Mailing address:
  • Phone: 864-292-5442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number StateSC

VIII. Authorized Official

Name: MRS. HESTER BEATRICE SCOTT
Title or Position: PRESIDENT
Credential:
Phone: 864-292-5442