WOODS BAY FAMILY CARE LLC (NPI# 1649623653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1649623653 |
Entity Type | Organization |
Organization Name | WOODS BAY FAMILY CARE LLC |
Practice Address |
128 E Baker St Olanta SC 29114-9101 |
Practice Telephone | 8436163410 |
Practice Fax Number | 8667074980 |
Mailing Telephone | 8436163410 |
Mailing Fax Number | 8667074980 |
Enumeration Date | 2016-07-14 |
Last Update Date | 2016-11-21 |
Authorized Official Name | MR. GEORGE MAXIE HARRISON III (PRESIDENT) |
Authorized Official Telephone | 8436163410 |
Authorized Official Credential | APRN FNP-C |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
Street Address |
128 E BAKER ST |
City | OLANTA |
State | SC |
Zip Code | 29114-9101 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518064229 | Pee Dee Healthcare Pa | Clinic/Center | 211 South Jones Road, Olanta, SC 29114 | 2006-09-17 |
1508809542 | Black River Healthcare, Inc. | Clinic/Center | 139 Main Street, Olanta, SC 29114 | 2006-06-14 |
1841272895 | Priscilla L Welch | Family Medicine | 211 South Jones Rd, Olanta, SC 29114 | 2005-11-16 |
1003043845 | Pee Dee Health Care, Pa | Clinic/Center | 211 South Jones Rd, Olanta, SC 29114 | 2009-06-19 |
1265535520 | Monica Michelle Vargas | Pharmacist | 223 N Jones Rd, Olanta, SC 29114 | 2006-09-05 |
1528172384 | Mary G. Daniels | Nurse Practitioner | 139 Main St, Olanta, SC 29114 | 2006-08-18 |
1306953096 | F & L Drug Store Inc | Pharmacy | 223 N Jones Rd, Olanta, SC 29114-0428 | 2006-08-25 |
1619995065 | Rebecca Ruth Haskill Strowd | Family Medicine | 139 Main Street, Olanta, SC 29114-0488 | 2006-07-17 |
1003253519 | Barbara Brown | Registered Nurse | 312 N. Jones Road, Olanta, SC 29114-0628 | 2013-05-24 |
1063859338 | Dixie M Floyd | Licensed Practical Nurse | 4006 Rhett Dr, Olanta, SC 29114-9366 | 2013-05-28 |
Find all providers in zip 29114 |
Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.