Carmilla Griffin

Individual provider Active NPI Contractor · Latta, SC

NPI 1376428805 · NPPES record last updated Aug 5, 2025

Key facts

NPI
1376428805
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
Practice address
301 Willis St
Latta, SC 29565-1739
Phone
(843) 773-1401
NPI assigned
Aug 5, 2025
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Yes

Addresses

Primary practice location

301 Willis St
Latta, SC 29565-1739

Mailing address

214 E McIntyre St Unit 1022
Mullins, SC 29574-3618
Phone (843) 773-1401

Other providers in Latta, SC

All providers in Latta, SC · Contractor in South Carolina

Sources for this page

Verify at the official NPI Registry.