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General NPI Number Information
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NPI Number | 1891810115
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Entity Type | Individual
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Provider Name | CARLOS AGUSTIN ANRRICH RN
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Gender | Male
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | THOMSON STUDENT HEALTH CTR UNIVERSITY OF SOUTH CAROLINA
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City | COLUMBIA
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State | SC
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Zip | 29208-0001
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Country | US
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Telephone | 803-777-3658
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Fax | 803-777-0126
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Provider Business Mailing Address
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Address Line | 100 HUNTERS POND DR
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City | COLUMBIA
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State | SC
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Zip | 29229-9041
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Country | US
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Telephone | 803-736-6780
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Fax | 803-777-0126
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | R53289
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License Number State | SC
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