Organization
SOUTHEASTERN ANESTHESIA ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETTA RICARD NOLES (OWNER)
(803) 917-1684
Entity
Organization
Contact information
Practice address
1 WELLNESS BLVD STE 111, IRMO, SC 29063-2873
(803) 749-3770
Mailing address
550 ROSE SHARON DR, LEXINGTON, SC 29072-7669
(803) 917-1684
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/15/2017
Last updated
09/15/2017
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