# CAROLINA SURGERY VEIN CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Legacy Health and Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285120741
- **Authorized official:** MARY MALLETTE WOODS (OFFICE MANAGER)
- **Authorized official phone:** (803) 547-6800

## Contact information

- **Practice address:** 127 BEN CASEY DR STE 106, FORT MILL, SC 29708
- **Practice address phone:** (803) 547-6800
- **Practice address fax:** (803) 547-6801
- **Mailing address:** 127 BEN CASEY DR STE 106, FORT MILL, SC 29708-6600
- **Mailing address phone:** (803) 547-6800
- **Mailing address fax:** (803) 547-6801

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/09/2018
- **Last updated:** 05/02/2019