Provider Demographics
NPI:1518747435
Name:EHRHARDT MEDICAL PRACTICE, LLC
Entity Type:Organization
Organization Name:EHRHARDT MEDICAL PRACTICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:CASSIDY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:803-267-2121
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:EHRHARDT
Mailing Address - State:SC
Mailing Address - Zip Code:29081-0309
Mailing Address - Country:US
Mailing Address - Phone:803-267-2121
Mailing Address - Fax:803-267-2124
Practice Address - Street 1:12930 BROXTON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:EHRHARDT
Practice Address - State:SC
Practice Address - Zip Code:29081
Practice Address - Country:US
Practice Address - Phone:803-267-2121
Practice Address - Fax:803-267-2124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty