Provider Demographics
NPI:1164489431
Name:CHILDREN FIRST MEDICAL CENTER
Entity Type:Organization
Organization Name:CHILDREN FIRST MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:UCHENNA
Authorized Official - Middle Name:LIZMAY
Authorized Official - Last Name:UMEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-273-4200
Mailing Address - Street 1:615 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HEATH SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29058-8677
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:615 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HEATH SPRINGS
Practice Address - State:SC
Practice Address - Zip Code:29058-8677
Practice Address - Country:US
Practice Address - Phone:803-273-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20696208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1275596124OtherNATIONAL PROVIDER NUMBER
SC1093770174OtherNATIONAL PROVIDER NUMBER