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General NPI Number Information
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NPI Number | 1205475001
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Entity Type | Organization
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Legal Business Name | WOODRUFF ROAD URGENT CARE CENTER, P.C.
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Dates
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Enumeration Date | 12/27/2019
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Last Update Date | 12/27/2019
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Provider Practice Location Address
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Address Line | 3613 HIGHWAY 153
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City | POWDERSVILLE
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State | SC
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Zip | 29611-7516
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Country | US
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Telephone | 864-307-8840
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Fax | 864-307-8841
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Provider Business Mailing Address
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Address Line | PO BOX 645576
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City | CINCINNATI
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State | OH
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Zip | 45264-5576
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Country | US
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Telephone | 864-307-8840
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Fax | 864-307-8841
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Authorized Official
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Title or Position | SECRETARY
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Name | TIMOTHY GROVES
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Credential |
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Telephone | 864-307-8672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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