Provider Demographics
NPI:1508343328
Name:NAPPY ROOTZ 15, LLC
Entity Type:Organization
Organization Name:NAPPY ROOTZ 15, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:0WNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTINA
Authorized Official - Middle Name:ALIN
Authorized Official - Last Name:SNIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-714-7514
Mailing Address - Street 1:393 CORNER SQUARE PLZ
Mailing Address - Street 2:
Mailing Address - City:MONCKS CORNER
Mailing Address - State:SC
Mailing Address - Zip Code:29461-3211
Mailing Address - Country:US
Mailing Address - Phone:843-714-7514
Mailing Address - Fax:
Practice Address - Street 1:393 CORNER SQUARE PLAZA
Practice Address - Street 2:
Practice Address - City:MONCKS CORNER
Practice Address - State:SC
Practice Address - Zip Code:29461
Practice Address - Country:US
Practice Address - Phone:843-714-7514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No335E00000XSuppliersProsthetic/Orthotic Supplier