Organization
BARR ENTERPRISES,LLC
Active
Other names
Advanced Vaccine Service
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICKY LADD MD (OWNER)
(803) 736-0442
Entity
Organization
Contact information
Practice address
112 NORSE DR, COLUMBIA, SC 29229-3304
(803) 466-6207
(803) 736-0442
Mailing address
112 NORSE DR, COLUMBIA, SC 29229-3304
(803) 466-6207
(803) 736-0442
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
20616
SC
Other
Enumeration date
09/10/2010
Last updated
09/10/2010
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