Blue Ridge Pediatrics Llc
LBN: Blue Ridge Pediatrics Llc
Blue Ridge Pediatrics Llc is an health care organization with primary practice located at 457-B Highway 123 Bypass , Seneca SC 29678. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, 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
457-B Highway 123 Bypass
Seneca SC 29678
Phone: (864) 888-4464
Fax: (864) 888-4462
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | 246601 | South Carolina |
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | 101794 | South Carolina |
Profile Details
| NPI number | 1457324907 |
|---|---|
| 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 | Feb 7th, 2006 |
| Last updated | Jan 25th, 2011 - about 13 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 | 1457324907 | NPPES |
| South Carolina | MEDICAID | RHC195 | |
| South Carolina | MEDICAID | GP1060 |
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