<Unavail>

LBN: John Sprouse
<Unavail> is an health care organization with primary practice located at 1513 Montague Avenue Ext , Greenwood SC 29649-9030. The organization recently has only one registered license in Suppliers / Prosthetic/Orthotic Supplier, which is considered as the primary health care specialty. John Sprouse can be contacted via phone (864) 229-3997, or through Sprouse, John via phone (864) 229-3997.

Contact Information

Primary practice address
1513 Montague Avenue Ext Greenwood SC 29649-9030
Phone: (864) 229-3997
Fax: (864) 388-9419
Website:
Map and Directions
Authorized official contact:
Name: Sprouse, John
Phone: (864) 229-3997

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Prosthetic/Orthotic Supplier 335E00000X

Profile Details

NPI number 1043471006
LBN Legal business name John Sprouse
DBA Doing business as <Unavail>
Authorized official Sprouse, John
Entity Organization
Organization subpart 1 No
Enumeration date Jun 23rd, 2008
Last updated Jun 17th, 2010 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043471006 NPPES
South Carolina MEDICAID DM0613

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