Chavis, Wayne
Chavis, Wayne is an sole proprietor health care provider with primary practice located at 7223 Kendallwood Ct , Fort Mill SC 29715-6219. He recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Physical Disabilities, which is considered as his primary health care specialty. Chavis, Wayne can be contacted via phone (803) 357-1105.Contact Information
Primary practice address
7223 Kendallwood Ct
Fort Mill SC 29715-6219
Phone: (803) 357-1105
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Residential Treatment Facility, Physical Disabilities | 320700000X | 364SHO200X | South Carolina |
Profile Details
| NPI number | 1417497314 |
|---|---|
| LBN Legal business name | Chavis, Wayne |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 27th, 2017 |
| Last updated | Feb 27th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417497314 | NPPES |
| South Carolina | MEDICAID | 364SHO200X |
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