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General NPI Number Information
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NPI Number | 1235209883
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Entity Type | Organization
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Legal Business Name | MORPHIS PEDIATRIC GROUP OF LANCASTER, P.A.
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 838 W MEETING ST STE A
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City | LANCASTER
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State | SC
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Zip | 29720-6233
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Country | US
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Telephone | 803-416-5295
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Fax | 803-416-5240
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Provider Business Mailing Address
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Address Line | 838 W MEETING ST STE A
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City | LANCASTER
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State | SC
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Zip | 29720-6233
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Country | US
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Telephone | 803-416-5295
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Fax | 803-416-5240
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. NANCY L BRACKETT
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Credential |
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Telephone | 803-416-5295
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State | SC
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