Covenant Family Allergy, Pc
LBN: Covenant Family Allergy, Pc
Covenant Family Allergy, Pc is an health care organization with primary practice located at 616 Edgefield Rd Suite 180, North Augusta SC 29841-1938. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as the primary health care specialty.
Covenant Family Allergy, Pc can be contacted via phone (803) 279-7666, or through Clark, Matthew T via phone (803) 441-8648.
Contact Information
Primary practice address
616 Edgefield Rd Suite 180
North Augusta SC 29841-1938
Phone: (803) 279-7666
Fax: (803) 279-0708
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | 28227 | South Carolina |
Profile Details
| NPI number | 1205002888 |
|---|---|
| LBN Legal business name | Covenant Family Allergy, Pc |
| DBA Doing business as | |
| Authorized official | Clark, Matthew T Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 5th, 2008 |
| Last updated | Apr 18th, 2013 - about 11 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 | 1205002888 | NPPES |
| South Carolina | Other | 28227 | STATE MEDICAL LICENSE |
| South Carolina | Other | 57156 | STATE MEDICAL LICENSE |
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