Moore Orthopaedic Clinic
LBN: Providence Orthopaedic Group
Moore Orthopaedic Clinic is an health care organization with primary practice located at 4721 Sunset Blvd Suite A, Lexington SC 29072-9151. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as the primary health care specialty.
Providence Orthopaedic Group can be contacted via phone (803) 227-8007, or through Mcnally, Sean via phone (803) 227-8152.
Contact Information
Primary practice address
4721 Sunset Blvd Suite A
Lexington SC 29072-9151
Phone: (803) 227-8007
Fax: (803) 996-3180
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 570521956 | South Carolina |
Profile Details
| NPI number | 1285674572 |
|---|---|
| LBN Legal business name | Providence Orthopaedic Group |
| DBA Doing business as | Moore Orthopaedic Clinic |
| Authorized official | Mcnally, Sean |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 7th, 2006 |
| Last updated | Jun 29th, 2010 - about 15 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 | 1285674572 | NPPES |
| South Carolina | Other | DM0194 | MEDICAID DME# |
| South Carolina | MEDICAID | PA0686 | MEDICAID DME# |
| South Carolina | Other | 14979900001 | MEDICAID DME# |
| South Carolina | Other | 570521956-009 | MEDICAID DME# |
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