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General NPI Number Information
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NPI Number | 1619656352
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Entity Type | Organization
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Legal Business Name | PELZER URGENT CARE LLC
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Dates
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Enumeration Date | 07/11/2023
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 323 LEBBY ST
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City | PELZER
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State | SC
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Zip | 29669-1754
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Country | US
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Telephone | 864-769-0210
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Fax | 888-498-4287
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Provider Business Mailing Address
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Address Line | 323 LEBBY ST
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City | PELZER
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State | SC
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Zip | 29669-1754
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Country | US
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Telephone | 864-307-9212
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DOMODHAR NERELLA
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Credential | MD
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Telephone | 864-847-2044
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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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