Southeastern Foundation & Crawlspace Repair, LLC

Primary specialty

ContractorTaxonomy code 171W00000X

Legal business name

SOUTHEASTERN FOUNDATION & CRAWLSPACE REPAIR, LLC

Practice address

100A E Dekalb St
Camden, SC 29020-4430

Phone

(803) 669-0117

NPI assigned

Oct 28, 2024

Last updated

Oct 28, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Paul Smith

Title

Owner

Phone

(803) 669-0117

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1417779869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 72",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290210072",
            "telephone_number": "803-669-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100A E DEKALB ST",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290204430",
            "telephone_number": "803-669-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN FOUNDATION & CRAWLSPACE REPAIR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-669-0117"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Smith
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• Jack Bernard Sorbo
• South Carolina CVS Pharmacy LLC (CVS Pharmacy #04281)
• South Carolina Heart Center PA
• Southeastern Success Center, LLC
• Jill Cullipher Souza, CRNA
• Kristy F Speronis, FNP
• Tiffany L. Sprinkle
• State of South Carolina (SC Dhec)

• Contractor in Camden, SC
• Providers in Camden, SC by specialty
• Contractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.