Provider Demographics
NPI:1700274032
Name:PARTNERS IN HEALTH - RURAL HEALTH
Entity Type:Organization
Organization Name:PARTNERS IN HEALTH - RURAL HEALTH
Other - Org Name:CLEMSON-SENECA PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:RIORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-797-7808
Mailing Address - Street 1:1 INDEPENDENCE PT
Mailing Address - Street 2:SUITE 212
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4545
Mailing Address - Country:US
Mailing Address - Phone:864-797-6044
Mailing Address - Fax:864-797-6198
Practice Address - Street 1:208 FRONTAGE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631-1691
Practice Address - Country:US
Practice Address - Phone:864-654-6034
Practice Address - Fax:864-654-0342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-09
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty