Provider Demographics
NPI:1134654494
Name:CANNADY AGENCY INC.
Entity Type:Organization
Organization Name:CANNADY AGENCY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:CANNADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-549-1846
Mailing Address - Street 1:305 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WALTERBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29488-3919
Mailing Address - Country:US
Mailing Address - Phone:843-549-1846
Mailing Address - Fax:843-549-6628
Practice Address - Street 1:305 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WALTERBORO
Practice Address - State:SC
Practice Address - Zip Code:29488-3919
Practice Address - Country:US
Practice Address - Phone:843-549-1846
Practice Address - Fax:843-549-6628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC224240251X00000X, 405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251X00000XAgenciesSupports BrokerageGroup - Multi-Specialty
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC024001OtherBLUE CROSS BLUE SHIELD OF SC