Provider Demographics
NPI:1770605925
Name:DAVIS AND DAVIS HEALTH CENTER
Entity type:Organization
Organization Name:DAVIS AND DAVIS HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ONEYKE
Authorized Official - Middle Name:NAPU
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:803-712-1911
Mailing Address - Street 1:176 GRANBURY LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-7556
Mailing Address - Country:US
Mailing Address - Phone:803-712-1911
Mailing Address - Fax:803-760-1888
Practice Address - Street 1:1089 COLUMBIA ROAD
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:SC
Practice Address - Zip Code:29229
Practice Address - Country:US
Practice Address - Phone:803-712-1911
Practice Address - Fax:803-760-1888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2146111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2283Medicaid
SCCH2146Medicaid
SC7715Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER