1417648916 NPI number — MRS. TIFFANY GRIFFIN APRN

Table of content: MRS. TIFFANY GRIFFIN APRN (NPI 1417648916)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417648916 NPI number — MRS. TIFFANY GRIFFIN APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRIFFIN
Provider First Name:
TIFFANY
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

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:
1417648916
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/16/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 847
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BATH
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29816-0847
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
839-777-8052
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SC HOUSE CALLS INC
Provider Second Line Business Practice Location Address:
111 DOCTORS CIRCLE
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-491-0909
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/16/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  225871 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: 27420 , 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)