| NPI | 1336684851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT RAMOS President / Owner 803-622-3559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: SC 19001) |
| Enumeration Date | 2016-12-20 |
| Last Update Date | 2016-12-20 |