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ASY ABSOLUTE WELLNESS CLINIC LLC NPI 1285922336


NPI Information

NPI: 1285922336
Provider Name: ASY ABSOLUTE WELLNESS CLINIC, LLC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
2712 MIDDLEBURG DR
SUITE 206
COLUMBIA, SC
ZIP 29204
Phone: (803) 335-1272
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ASY ABSOLUTE WELLNESS CLINIC, LLC is a specialist in Columbia, SC. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ASY ABSOLUTE WELLNESS CLINIC, LLC NPI is 1285922336. The provider is registered as an organization entity type.

The provider's business location address is:

2712 MIDDLEBURG DR
SUITE 206
COLUMBIA, SC
ZIP 29204-415
Phone: (803) 335-1272
Fax: (803) 335-1272

The provider's authorized official is Christopher Young .
The authorized official title is Partner/staff and has the following contact phone number (803) 335-1272.

The enumeration date for this NPI number is 7/11/2011 and was last updated on 6/18/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1291U00000XClinical Medical Laboratory42D2033880SOUTH CAROLINANo
2261QM0855XClinic/CenterAdolescent and Children Mental Health22943SOUTH CAROLINANo
3174400000XSpecialistGP5785Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GP5785MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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