Organization
BAPTIST EASLEY
Active
Other names
Heritage Pediatrics & Internal Medicine Wren
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES LARRY POPE (FINANCE DIRECTOR/CFO)
(864) 552-7610
Entity
Organization
Contact information
Practice address
1115 WREN SCHOOL RD, PIEDMONT, SC 29673-8033
(864) 859-0740
(864) 859-9008
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
(864) 797-6198
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP5967
—
SC
Enumeration date
08/15/2013
Last updated
08/15/2013
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