Organization
CCLC OBS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE PARKER (MEDICAL DIRECTOR)
(864) 286-3700
Entity
Organization
Contact information
Practice address
121 HALTON VILLAGE CIR, GREENVILLE, SC 29607-6825
(864) 286-3700
Mailing address
121 HALTON VILLAGE CIR, GREENVILLE, SC 29607-6825
(864) 286-3700
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QS0132X
Ophthalmologic Surgery Clinic/Center
—
—
Other
Enumeration date
06/05/2024
Last updated
06/05/2024
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