Southside Medical Center Pa

LBN: Southside Medical Center Pa
Southside Medical Center Pa is an health care organization with primary practice located at 3921 S Highway 14 Ste A , Greenville SC 29615-6138. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Southside Medical Center Pa can be contacted via phone (864) 288-2006, or through Joudeh, Thaer via phone (864) 288-2006.

Contact Information

Primary practice address
3921 S Highway 14 Ste A Greenville SC 29615-6138
Phone: (864) 288-2006
Fax: (864) 288-1678
Website:
Map and Directions
Authorized official contact:
Name: Joudeh, Thaer Doctor of Medicine (MD)
Phone: (864) 288-2006

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X 21696 South Carolina

Profile Details

NPI number 1972782019
LBN Legal business name Southside Medical Center Pa
DBA Doing business as
Authorized official Joudeh, Thaer Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 25th, 2007
Last updated Oct 25th, 2007 - about 17 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 1972782019 NPPES
South Carolina MEDICAID 216965

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