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General NPI Number Information
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NPI Number | 1639026016
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Entity Type | Organization
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Legal Business Name | HOMEGROWN PEDIATRICS, LLC
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Dates
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Enumeration Date | 03/13/2026
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 318 MCARN RD
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City | RIDGEVILLE
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State | SC
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Zip | 29472-8811
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Country | US
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Telephone | 803-974-0044
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Fax |
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Provider Business Mailing Address
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Address Line | 318 MCARN RD
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City | RIDGEVILLE
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State | SC
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Zip | 29472-8811
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Country | US
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Telephone | 803-974-0044
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHELSEA MASTERS
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Credential | CPNP
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Telephone | 803-974-0055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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