Gross Family Practice Llc

LBN: Gross Family Practice Llc
Gross Family Practice Llc is an health care organization with primary practice located at 970 Holly St , Orangeburg SC 29115-4930. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Rural Health. Ambulatory Health Care Facilities / Rural Health is the primary health care specialty. Gross Family Practice Llc can be contacted via phone (803) 531-2722, or through Haygood, Verdell F via phone (803) 531-2722.

Contact Information

Primary practice address
970 Holly St Orangeburg SC 29115-4930
Fax: (803) 531-2743
Website:
Authorized official contact:
Name: Haygood, Verdell F

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0646 South Carolina
Ambulatory Health Care Facilities / Rural Health 261QR1300X

Profile Details

NPI number 1083961114
LBN Legal business name Gross Family Practice Llc
DBA Doing business as
Authorized official Haygood, Verdell F
Entity Organization
Organization subpart 1 No
Enumeration date Aug 8th, 2012
Last updated Sep 21st, 2012 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083961114 NPPES
South Carolina Other H410155677 MEDICARE ID
South Carolina MEDICAID T00617 MEDICARE ID

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