| Goldenrod Logistics Monitoring Llc | |
|
1304 Sunset Blvd # 203 West Columbia SC 29169-5914 | |
| (866) 374-6628 | |
| (866) 951-1120 |
| Full Name | Goldenrod Logistics Monitoring Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 1304 Sunset Blvd # 203, West Columbia, South Carolina |
| Authorized Official Name and Position | Kelly Mcclintock (COMPLIANCE OFFICER) |
| Authorized Official Contact | 8663746628 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Goldenrod Logistics Monitoring Llc Po Box 1486 San Antonio TX 78295-1486 Ph: () - | Goldenrod Logistics Monitoring Llc 1304 Sunset Blvd # 203 West Columbia SC 29169-5914 Ph: (866) 374-6628 |
| NPI Number | 1184142176 |
|---|---|
| Provider Enumeration Date | 08/30/2017 |
| Last Update Date | 06/06/2022 |
| Certification Date | 06/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184142176 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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