Organization
PHYSICIAN MANAGEMENT SERVICES OF SOUTH CAROLINA, LLC
Active
Parent organization
VAXCARE CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
VAXCARE CORPORATION
Authorized official
CASEY DELOACH (PRESIDENT)
(888) 829-8550
Entity
Organization
Contact information
Practice address
135 BOTANICAL CIR, TRAVELERS REST, SC 29690-7112
(859) 514-5547
(859) 422-4907
Mailing address
3113 LAWTON RD STE 250, ORLANDO, FL 32803-3517
(888) 298-5508
(855) 418-9149
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/24/2011
Last updated
04/27/2021
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