Physician'S Pain And Spine Center, Llc

LBN: Physician'S Pain And Spine Center, Llc
Physician'S Pain And Spine Center, Llc is an health care organization with primary practice located at 3227-F Sunset Blvd. Suite 102, West Coumbia SC 29169-3201. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is the primary health care specialty. Physician'S Pain And Spine Center, Llc can be contacted via phone (803) 724-2336, or through Grosslight, Kenneth Russell via phone (803) 724-2336.

Contact Information

Primary practice address
3227-F Sunset Blvd. Suite 102 West Coumbia SC 29169-3201
Phone: (803) 724-2336
Fax: (803) 724-2317
Website:
Map and Directions
Authorized official contact:
Name: Grosslight, Kenneth Russell MD, JD
Phone: (803) 724-2336

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X South Carolina

Profile Details

NPI number 1336475573
LBN Legal business name Physician'S Pain And Spine Center, Llc
DBA Doing business as
Authorized official Grosslight, Kenneth Russell MD, JD
Entity Organization
Organization subpart 1 No
Enumeration date Oct 22nd, 2009
Last updated Jul 18th, 2015 - about 11 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 1336475573 NPPES
South Carolina MEDICAID GP5286

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