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General NPI Number Information
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NPI Number | 1518929835
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Entity Type | Organization
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Legal Business Name | CAROLINA HEALTH CENTERS, INC.
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Dates
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Enumeration Date | 04/03/2006
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Last Update Date | 10/28/2008
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Provider Practice Location Address
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Address Line | 102 KATIE CT
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City | GREENWOOD
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State | SC
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Zip | 29646-4068
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Country | US
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Telephone | 864-227-2022
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Fax | 864-227-2791
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Provider Business Mailing Address
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Address Line | 102 KATIE CT
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City | GREENWOOD
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State | SC
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Zip | 29646-4068
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Country | US
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Telephone | 864-227-2022
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Fax | 864-227-2791
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Authorized Official
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Title or Position | PHYSICIAN OBGYN
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Name | ROY PHILLIP BAKER
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Credential | MD
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Telephone | 864-227-2022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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