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COVENANT FAMILY ALLERGY PC NPI 1205002888


NPI Information

NPI: 1205002888
Provider Name: COVENANT FAMILY ALLERGY, PC
Classification: Allergy & Immunology - 207K00000X
Entity Type: Organization
Address:
616 EDGEFIELD RD
SUITE 180
NORTH AUGUSTA, SC
ZIP 29841
Phone: (803) 279-7666
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COVENANT FAMILY ALLERGY, PC is an allergy immunology in North Augusta, SC. The provider is an allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. COVENANT FAMILY ALLERGY, PC NPI is 1205002888. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

616 EDGEFIELD RD
SUITE 180
NORTH AUGUSTA, SC
ZIP 29841-938
Phone: (803) 279-7666
Fax: (803) 279-0708

The provider's authorized official is Matthew T Clark .
The authorized official title is Physician/owner and has the following contact phone number (803) 441-8648.

The enumeration date for this NPI number is 5/5/2008 and was last updated on 4/18/2013.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207K00000XAllergy & Immunology28227SOUTH CAROLINAYes

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
128227OTHERSOUTH CAROLINASTATE MEDICAL LICENSE
257156OTHERGEORGIASTATE MEDICAL LICENSE

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: 5/5/2024

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