PROACTIVE MSO LLC NPI 1619551744

NPI Information

  • NPI: 1619551744
  • Provider Name: PROACTIVE MSO, LLC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Address: 124 ALLAWOOD CT
    SIMPSONVILLE, SC
    ZIP 29681
  • Phone: (864) 501-0751

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NPI Details

PROACTIVE MSO, LLC is a primary care clinic center in Simpsonville, SC. PROACTIVE MSO, LLC NPI is 1619551744. The provider is registered as an organization entity type.

The provider's business location address is:

124 ALLAWOOD CT
SIMPSONVILLE, SC
ZIP 29681-207
Phone: (864) 501-0751

The provider's authorized official is Amanda James .
The authorized official title is Coo and has the following contact phone number (913) 208-2085.

The enumeration date for this NPI number is 5/5/2021 and was last updated on 7/25/2024.

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
1261QP2300XClinic/CenterPrimary CareYes

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: 3/30/2025

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