Provider Demographics
NPI:1891712576
Name:TUOMEY GASTROENTEROLOGY SERVICES
Entity Type:Organization
Organization Name:TUOMEY GASTROENTEROLOGY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO/ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:LUEBBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-774-5290
Mailing Address - Street 1:PO BOX 3540
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29151-3540
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:129 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4949
Practice Address - Country:US
Practice Address - Phone:803-778-1941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUOMEY PROFESSIONAL SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-17
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP4058Medicaid
SCDC8858OtherRRMEDICARE
SCDC8858OtherRRMEDICARE