1407075187 NPI number — THE HAND CENTER PA

Table of content: (NPI 1407075187)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407075187 NPI number — THE HAND CENTER PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE HAND CENTER PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407075187
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1011 FRONTAGE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENVILLE
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29615-4240
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-242-4263
Provider Business Mailing Address Fax Number:
864-331-0714

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10630 CLEMSON BLVD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
SENECA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29678-4546
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-888-3466
Provider Business Practice Location Address Fax Number:
864-482-7000
Provider Enumeration Date:
04/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MORGAN
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
S
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
864-242-4263

Provider Taxonomy Codes

  • Taxonomy code: 2086S0105X , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: GP0496 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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