Provider Demographics
NPI:1760555346
Name:LAWLER AND ASSOCIATES, LLC
Entity Type:Organization
Organization Name:LAWLER AND ASSOCIATES, LLC
Other - Org Name:PASSPORT HEALTH OF GSP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LAWLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS
Authorized Official - Phone:864-640-8154
Mailing Address - Street 1:38 BOLAND CT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-5707
Mailing Address - Country:US
Mailing Address - Phone:864-640-8154
Mailing Address - Fax:864-990-2249
Practice Address - Street 1:38 BOLAND CT
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-5707
Practice Address - Country:US
Practice Address - Phone:864-640-8154
Practice Address - Fax:864-990-2249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCR38945261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service