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General NPI Number Information
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NPI Number | 1356786750
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Entity Type | Organization
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Legal Business Name | PARTNERS FOR CHANGE OF THE CAROLINAS
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Dates
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Enumeration Date | 04/30/2013
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 110 SOUTH WASHINGTON STREET
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City | SUMTER
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State | SC
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Zip | 29150
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Country | US
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Telephone | 803-360-7896
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Fax | 803-888-2648
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Provider Business Mailing Address
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Address Line | 110 SOUTH WASHINGTON STREET
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City | SUMTER
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State | SC
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Zip | 29150
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Country | US
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Telephone | 803-360-7896
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Fax | 803-888-2648
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Authorized Official
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Title or Position | DIRECTOR
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Name | VALENCIA GISELLE GRAY-WILLIAMS
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Credential | PHARMD
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Telephone | 803-360-7896
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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