Gross Family Practice Llc
LBN: Gross Family Practice Llc
Gross Family Practice Llc is an health care organization with primary practice located at 970 Holly St , Orangeburg SC 29115-4930. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Rural Health. Ambulatory Health Care Facilities / Rural Health is the primary health care specialty.
Gross Family Practice Llc can be contacted via phone (803) 531-2722, or through Haygood, Verdell F via phone (803) 531-2722.
Contact Information
Primary practice address
970 Holly St
Orangeburg SC 29115-4930
Phone: (803) 531-2722
Fax: (803) 531-2743
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 0646 | South Carolina |
| Ambulatory Health Care Facilities / Rural Health | 261QR1300X |
Profile Details
| NPI number | 1083961114 |
|---|---|
| LBN Legal business name | Gross Family Practice Llc |
| DBA Doing business as | |
| Authorized official | Haygood, Verdell F |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 8th, 2012 |
| Last updated | Sep 21st, 2012 - about 14 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083961114 | NPPES |
| South Carolina | Other | H410155677 | MEDICARE ID |
| South Carolina | MEDICAID | T00617 | MEDICARE ID |
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