Blue Ridge Pediatrics Llc

LBN: Blue Ridge Pediatrics Llc
Blue Ridge Pediatrics Llc is an health care organization with primary practice located at 457B Highway 123 , Seneca SC 29678-0842. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rural Health, which is considered as the primary health care specialty. Blue Ridge Pediatrics Llc can be contacted via phone (864) 888-4464, or through Gully, Carey Molin via phone (864) 888-4464.

Contact Information

Primary practice address
457B Highway 123 Seneca SC 29678-0842
Phone: (864) 888-4464
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Gully, Carey Molin Doctor of Medicine (MD)
Phone: (864) 888-4464

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X 261QR1300X South Carolina

Profile Details

NPI number 1104130376
LBN Legal business name Blue Ridge Pediatrics Llc
DBA Doing business as
Authorized official Gully, Carey Molin Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 30th, 2010
Last updated Jul 30th, 2010 - about 15 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 1104130376 NPPES
South Carolina MEDICAID RHC195

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