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General NPI Number Information
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NPI Number | 1588849830
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Entity Type | Organization
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Legal Business Name | A&Z UNITEDHEALTH
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 01/07/2008
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Provider Practice Location Address
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Address Line | 401 CAPE JASMINE WAY
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City | LEXINGTON
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State | SC
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Zip | 29073-6960
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Country | US
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Telephone | 803-546-3279
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Fax |
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Provider Business Mailing Address
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Address Line | 401 CAPE JASMINE WAY
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City | LEXINGTON
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State | SC
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Zip | 29073-6960
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Country | US
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Telephone | 803-546-3279
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WILLIAM ZACHERY RILEY
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Credential |
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Telephone | 803-556-3210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 20073460933738
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License Number State | SC
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