Provider Demographics
NPI:1184794091
Name:ADAMY D DIAZ-CARPENTER
Entity type:Organization
Organization Name:ADAMY D DIAZ-CARPENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAMY
Authorized Official - Middle Name:D
Authorized Official - Last Name:DIAZ-CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:864-848-1232
Mailing Address - Street 1:701 W POINSETT ST
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-1318
Mailing Address - Country:US
Mailing Address - Phone:864-848-1232
Mailing Address - Fax:864-989-0106
Practice Address - Street 1:701 W POINSETT ST
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-1451
Practice Address - Country:US
Practice Address - Phone:864-848-1232
Practice Address - Fax:864-989-0106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty