Provider Demographics
NPI:1992961122
Name:INMAN FAMILY MEDICINE, LLC
Entity type:Organization
Organization Name:INMAN FAMILY MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:INMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-662-5222
Mailing Address - Street 1:1003 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501
Mailing Address - Country:US
Mailing Address - Phone:843-662-5222
Mailing Address - Fax:843-662-5776
Practice Address - Street 1:1594 FREEDOM BOULEVARD
Practice Address - Street 2:SUITE 103
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505
Practice Address - Country:US
Practice Address - Phone:843-662-5222
Practice Address - Fax:843-662-5776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22347261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCH62103Medicare UPIN