DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

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Active Organization

Point of Service · MOORE, SC

Registration Details

NPI Number
1164200812
Provider Type
Organization
NPI Issued
Sep 14, 2023 (2.6021098269191 yrs)
Last Updated
Sep 14, 2023

Practice Information

Address
511 SIERRA RIDGE CT
MOORE, SC, 293699383
Browse SC providers · Browse ZIP 29369
Phone
8643579701
Primary Specialty
Point of Service
305S00000X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.