BLUE RIDGE PEDIATRICS LLC NPI 1154450757

NPI Information

NPI: 1154450757
Provider Name: BLUE RIDGE PEDIATRICS LLC
Classification: Clinic/Center - 261QR1300X
Specialization: Rural Health
Entity Type: Organization
Address: 457 B HWY 123 BYPASS
SENECA, SC
ZIP 29678
Phone: (864) 888-4464

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NPI Details

BLUE RIDGE PEDIATRICS LLC is a rural health clinic center in Seneca, SC. BLUE RIDGE PEDIATRICS LLC NPI is 1154450757. The provider is registered as an organization entity type.

The provider's business location address is:

457 B HWY 123 BYPASS
SENECA, SC
ZIP 29678
Phone: (864) 888-4464
Fax: (864) 888-4462

The provider's authorized official is Carey Molin Gully .
The authorized official title is Owner and has the following contact phone number (864) 888-4464.

The enumeration date for this NPI number is 3/2/2007 and was last updated on 6/30/2009.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	RHC 100	OTHER	SOUTH CAROLINA	RURAL HEALTH CLINIC

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: 11/21/2025

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