Provider Demographics
NPI:1568791895
Name:LAURENS COUNTY HEALTH CARE SYSTEM
Entity Type:Organization
Organization Name:LAURENS COUNTY HEALTH CARE SYSTEM
Other - Org Name:LAURENS COUNTY ANESTHESIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FISCAL AND SUPPORT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:WILL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-833-3976
Mailing Address - Street 1:22725 HWY 76
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:SC
Mailing Address - Zip Code:29325-7527
Mailing Address - Country:US
Mailing Address - Phone:864-833-9141
Mailing Address - Fax:864-833-9357
Practice Address - Street 1:22725 HWY 76
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:SC
Practice Address - Zip Code:29325-7527
Practice Address - Country:US
Practice Address - Phone:864-833-9141
Practice Address - Fax:864-833-9357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist AssistantGroup - Multi-Specialty