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General NPI Number Information
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NPI Number | 1568791895
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Entity Type | Organization
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Legal Business Name | LAURENS COUNTY HEALTH CARE SYSTEM
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Dates
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Enumeration Date | 12/16/2009
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Last Update Date | 12/16/2009
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Provider Practice Location Address
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Address Line | 22725 HWY 76
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City | CLINTON
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State | SC
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Zip | 29325-7527
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Country | US
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Telephone | 864-833-9141
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Fax | 864-833-9357
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Provider Business Mailing Address
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Address Line | 22725 HWY 76
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City | CLINTON
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State | SC
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Zip | 29325-7527
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Country | US
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Telephone | 864-833-9141
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Fax | 864-833-9357
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Authorized Official
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Title or Position | VP OF FISCAL AND SUPPORT SERVICES
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Name | WILL GRANT
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Credential |
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Telephone | 864-833-3976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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