Provider Demographics
NPI:1073836383
Name:SYCAMORE HEALTH CARE, LLC
Entity Type:Organization
Organization Name:SYCAMORE HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:CONE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, BC
Authorized Official - Phone:803-632-3900
Mailing Address - Street 1:P.O. BOX 96
Mailing Address - Street 2:7205 BUFORD'S BRIDGE HWY.
Mailing Address - City:SYCAMORE
Mailing Address - State:SC
Mailing Address - Zip Code:29846
Mailing Address - Country:US
Mailing Address - Phone:803-632-3900
Mailing Address - Fax:803-632-3901
Practice Address - Street 1:7205 BUFORD'S BRIDGE HWY.
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:SC
Practice Address - Zip Code:29846
Practice Address - Country:US
Practice Address - Phone:803-632-3900
Practice Address - Fax:803-632-3901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN 1447363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty