Organization
DUE WEST FAMILY MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN NELSON HENRY MD (OWNER)
(864) 379-2345
Entity
Organization
Contact information
Practice address
6 COLLEGE ST, DUE WEST, SC 29639
(864) 379-2345
(864) 379-3228
Mailing address
PO BOX 638, DUE WEST, SC 29639-0638
(864) 379-2345
(864) 379-3228
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHC074
—
SC
Enumeration date
11/28/2006
Last updated
01/17/2013
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