# RADDON LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861972853
- **Authorized official:** ROGER N PHILLIPS (MANAGER)
- **Authorized official phone:** (770) 335-9797

## Contact information

- **Practice address:** 114 GATEWAY CORPORATE BLVD STE 220, COLUMBIA, SC 29203-9785
- **Practice address phone:** (770) 335-9797
- **Practice address fax:** (803) 849-8247
- **Mailing address:** 114 GATEWAY CORPORATE BLVD STE 220, COLUMBIA, SC 29203-9785
- **Mailing address phone:** (770) 335-9797

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/18/2018
- **Last updated:** 06/23/2022