Providence Family Practice Llc
LBN: Providence Family Practice Llc
Providence Family Practice Llc is an health care organization with primary practice located at 2750 Laurel St Suite 103, Columbia SC 29204-2023. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty.
Providence Family Practice Llc can be contacted via phone (803) 254-5171, or through Henderson, Frampton W via phone (803) 254-5171.
Contact Information
Primary practice address
2750 Laurel St Suite 103
Columbia SC 29204-2023
Phone: (803) 254-5171
Fax: (803) 779-7403
Website:
Authorized official contact:
Name: Henderson, Frampton W Doctor of Medicine (MD)
Phone: (803) 254-5171
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 8387 | South Carolina |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 13507 | South Carolina |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 21987 | South Carolina |
Profile Details
| NPI number | 1528066115 |
|---|---|
| LBN Legal business name | Providence Family Practice Llc |
| DBA Doing business as | |
| Authorized official | Henderson, Frampton W Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 8th, 2005 |
| Last updated | Jun 23rd, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528066115 | NPPES |
| South Carolina | MEDICAID | GP2164 | |
| South Carolina | Other | CM5571 |
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