Lifesource Of North Carolina

LBN: Lifesource Of North Carolina
Lifesource Of North Carolina is an health care organization with primary practice located at 939 Springdale Dr , Clinton SC 29325-7266. The organization recently has 6 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / General Practice, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Allopathic & Osteopathic Physicians / General Practice is the primary health care specialty. Lifesource Of North Carolina can be contacted via phone (910) 742-9243, or through Baddour, Peggy L via phone (910) 777-9165.

Contact Information

Primary practice address
939 Springdale Dr Clinton SC 29325-7266
Phone: (910) 742-9243
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Baddour, Peggy L
Phone: (910) 777-9165

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X
Allopathic & Osteopathic Physicians / General Practice 208D00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X

Profile Details

NPI number 1972861789
LBN Legal business name Lifesource Of North Carolina
DBA Doing business as
Authorized official Baddour, Peggy L
Entity Organization
Organization subpart 1 No
Enumeration date Apr 30th, 2012
Last updated May 17th, 2022 - about 3 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 1972861789 NPPES
South Carolina MEDICAID GP5917

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