MEDICARE: CAROLINE R. PRICE MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center	22781	SC

General Provider Information

NPI Number	:	1730225178
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINE R. PRICE MD PA

Provider Business Mailing Address
First Line	:	10 ENTERPRISE BLVD STE 107
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29615-3534
Country	:	US
Telephone Number	:	864-331-2505
Fax Number	:	864-331-2510

Provider Business Practice Location Address
First Line	:	10 ENTERPRISE BLVD STE 107
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29615-3534
Country	:	US
Telephone Number	:	864-331-2505
Fax Number	:	864-331-2510

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CAROLINE R. PRICE
Credential	:	MD
Telephone Number	:	864-331-2505

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	11/21/2011

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