Provider Demographics
NPI:1831323831
Name:LANDRUM FAMILY HEALTH CARE LLC
Entity Type:Organization
Organization Name:LANDRUM FAMILY HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WOODFIN-HIGHTOWER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:864-457-2363
Mailing Address - Street 1:PO BOX 657
Mailing Address - Street 2:
Mailing Address - City:LANDRUM
Mailing Address - State:SC
Mailing Address - Zip Code:29356-0657
Mailing Address - Country:US
Mailing Address - Phone:864-457-2363
Mailing Address - Fax:864-457-2736
Practice Address - Street 1:108 W RUTHERFORD ST
Practice Address - Street 2:
Practice Address - City:LANDRUM
Practice Address - State:SC
Practice Address - Zip Code:29356-1526
Practice Address - Country:US
Practice Address - Phone:864-457-2363
Practice Address - Fax:864-457-2736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC42-8995OtherMEDICARE RURAL HEALTH
SCGP5191Medicaid
SCRHC183OtherMEDICAID RURAL HEALTH
NC7000470Medicaid