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Organization

PEDIATRIC EVENING CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RALPH H JOHNS MD (OWNER)
(864) 591-0311
Entity
Organization

Contact information

Practice address
451A E SAINT JOHN ST, SPARTANBURG, SC 29302-1623
(864) 591-0311
(864) 591-0744
Mailing address
451A E SAINT JOHN ST, SPARTANBURG, SC 29302-1623
(864) 591-0311
(864) 591-0744

Taxonomy

Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
17001
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
170013
SC
Enumeration date
12/22/2005
Last updated
08/22/2020
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