Provider Demographics
NPI:1992411441
Name:BACK TO BASICS HEALTH CARE SERVICES LLP
Entity type:Organization
Organization Name:BACK TO BASICS HEALTH CARE SERVICES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:QUINCY
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:803-529-9000
Mailing Address - Street 1:821 BRICKINGHAM WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-9551
Mailing Address - Country:US
Mailing Address - Phone:803-529-9003
Mailing Address - Fax:803-306-6706
Practice Address - Street 1:821 BRICKINGHAM WAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-9551
Practice Address - Country:US
Practice Address - Phone:803-529-9003
Practice Address - Fax:803-306-6706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service