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BEAR MOUNTAIN MEDICINE INC NPI 1538220645


NPI Information

NPI: 1538220645
Provider Name: BEAR MOUNTAIN MEDICINE INC
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 05D1066900

Address:
2312 RUSHLAND LANDING RD
JOHNS ISLAND, SC
ZIP 29455
Phone: (661) 433-6321
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BEAR MOUNTAIN MEDICINE INC is a general practice in Johns Island, SC. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee BEAR MOUNTAIN MEDICINE INC NPI is 1538220645. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2312 RUSHLAND LANDING RD
JOHNS ISLAND, SC
ZIP 29455-753
Phone: (661) 433-6321
Fax: (909) 878-3697

The provider's authorized official is Donald Steven Combs .
The authorized official title is Ceo and has the following contact phone number (661) 433-6321.

The CLIA number assigned to this NPI record is 05D1066900 - other - urgent care with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/12/2006 and was last updated on 12/8/2023.


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
1208D00000XGeneral PracticeYes

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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