Grandy Chiropractic Clinic, LLC

Organization Active NPI Chiropractor · Batesburg, SC

NPI 1306315528 · NPPES record last updated Apr 8, 2021

Key facts

NPI
1306315528
Entity type
Organization (NPI type 2)
Primary specialty
Chiropractor 111N00000X
Legal business name
GRANDY CHIROPRACTIC CLINIC, LLC
Practice address
653 West Columbia Avenue
Batesburg, SC 29006
Phone
(803) 532-3180
Fax
(803) 532-3180
NPI assigned
Nov 16, 2018
Organization subpart
No

Authorized official

Name
Dr. Bob Richard Grandy, DC
Title
Owner
Phone
(803) 532-3180

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20210524000261 SC Part B Supplier - Clinic/Group Practice 2860891900 Receives reassigned benefits from 2 practitioners
Practice locations: Batesburg, SC

National Provider Directory

Locations

653 W Columbia Ave
Batesburg Leesville, SC 29006
Phone (803) 532-3180

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP
111N00000X Yes

Addresses

Primary practice location

653 West Columbia Avenue
Batesburg, SC 29006

Mailing address

P.O. Box 2300
Leesville, SC 29070
Phone (803) 532-3180

Other providers in Batesburg, SC

All providers in Batesburg, SC · Chiropractor in South Carolina

Sources for this page

Verify at the official NPI Registry.