Organization
SOUTHEAST PULMONARY AND CRITICAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAY W SPENCE (ADMINISTRATOR)
(803) 980-5864
Entity
Organization
Contact information
Practice address
370 S HERLONG AVE, SUITE 200, ROCK HILL, SC 29732-1160
(803) 980-5864
(803) 980-5817
Mailing address
370 HERLONG AVE S STE 200, ROCK HILL, SC 29732-1160
(803) 980-5864
(803) 980-5817
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
21599
SC
261QP2300X
Primary Care Clinic/Center
21599
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
215992
—
SC
Enumeration date
02/23/2011
Last updated
04/03/2026
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