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General NPI Number Information
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NPI Number | 1437146537
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Entity Type | Organization
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Legal Business Name | PIEDMONT EAST URGENT CARE CENTER LLC
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Dates
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Enumeration Date | 10/04/2005
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Last Update Date | 09/17/2010
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Provider Practice Location Address
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Address Line | 760 ADDISON AVENUE
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City | ROCK HILL
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State | SC
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Zip | 29730-8097
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Country | US
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Telephone | 803-329-1930
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Fax | 803-328-2549
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Provider Business Mailing Address
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Address Line | PO BOX 741323
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City | ATLANTA
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State | GA
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Zip | 30384-1323
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Country | US
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Telephone | 803-329-1930
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Fax | 803-328-2549
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. JOHN HOLLAND
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Credential |
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Telephone | 469-893-2030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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