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General NPI Number Information
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NPI Number | 1952252330
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Entity Type | Organization
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Legal Business Name | UPCOUNTRY PRIMARY CARE
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Dates
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Enumeration Date | 02/03/2026
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 1736 OLD YORK RD
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City | YORK
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State | SC
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Zip | 29745-9458
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Country | US
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Telephone | 864-685-7915
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Fax |
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Provider Business Mailing Address
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Address Line | 6 BROAD ST
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City | YORK
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State | SC
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Zip | 29745-1112
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Country | US
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Telephone | 803-981-4962
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Fax |
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Authorized Official
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Title or Position | CEO / PRESIDENT
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Name | GRETCHEN COADY
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Credential | MD
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Telephone | 803-981-4962
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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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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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