PFC LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2201 Issued in SC

Legal business name

PFC LLC

Practice address

101B Medical Sciences Dr
Union, SC 29379-8609

Phone

(864) 429-2912

Fax

(866) 294-2912

NPI assigned

Jun 12, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Wallace Harold Privette Jr., DC

Title

Ceo

Phone

(864) 680-6802

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528761600000",
    "number": "1154814416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N. GOULD ST, SUITE 7673",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "82801",
            "telephone_number": "307-763-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101B MEDICAL SCIENCES DR",
            "city": "UNION",
            "state": "SC",
            "postal_code": "293798609",
            "telephone_number": "864-429-2912",
            "fax_number": "866-294-2912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PFC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-12",
        "last_updated": "2018-06-12",
        "status": "A",
        "authorized_official_last_name": "PRIVETTE",
        "authorized_official_first_name": "WALLACE",
        "authorized_official_middle_name": "HAROLD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "864-680-6802",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Union, SC
• Providers in Union, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.