Provider Demographics
NPI:1588849830
Name:A&Z UNITEDHEALTH
Entity Type:Organization
Organization Name:A&Z UNITEDHEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ZACHERY
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-556-3210
Mailing Address - Street 1:401 CAPE JASMINE WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-6960
Mailing Address - Country:US
Mailing Address - Phone:803-546-3279
Mailing Address - Fax:
Practice Address - Street 1:401 CAPE JASMINE WAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-6960
Practice Address - Country:US
Practice Address - Phone:803-546-3279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20073460933738251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)