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General NPI Number Information
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NPI Number | 1326548520
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Entity Type | Organization
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Legal Business Name | CARETEAM HEALTH ONSITE CLINIC / CITIZENS AND FARMERS BANK
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Dates
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Enumeration Date | 02/15/2018
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Last Update Date | 02/15/2018
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Provider Practice Location Address
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Address Line | 901 E CARY ST STE 1100
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City | RICHMOND
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State | VA
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Zip | 23219-4037
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Country | US
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Telephone | 843-729-0316
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1875
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City | MOUNT PLEASANT
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State | SC
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Zip | 29465-1875
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Country | US
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Telephone | 757-810-9278
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. SAM JONES
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Credential |
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Telephone | 843-469-1744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number |
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License Number State |
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