Provider Demographics
NPI:1952637613
Name:MEC SURGICAL LLC
Entity Type:Organization
Organization Name:MEC SURGICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:RANDALL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:803-329-8500
Mailing Address - Street 1:1665 HERLONG CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-1193
Mailing Address - Country:US
Mailing Address - Phone:803-329-8500
Mailing Address - Fax:803-329-8511
Practice Address - Street 1:1665 HERLONG CT
Practice Address - Street 2:SUITE A
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1193
Practice Address - Country:US
Practice Address - Phone:803-329-8500
Practice Address - Fax:803-329-8511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty