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Organization
THE BHANG GROUP
Active
Organization
THE BHANG GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRUNETTA BRUNSON NP (CEO)
(803) 724-1250
Entity
Organization
Contact information
Practice address
1320 MAIN ST STE 300, COLUMBIA, SC 29201-3266
(803) 724-1250
(803) 724-1200
Mailing address
1320 MAIN ST STE 300, COLUMBIA, SC 29201-3266
(803) 724-1250
(803) 724-1200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8820353071
—
SC
Enumeration date
10/04/2019
Last updated
10/04/2019
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