Provider Demographics
NPI:1902284631
Name:INFINITE WELLNESS OF ROCK HILL LLC
Entity Type:Organization
Organization Name:INFINITE WELLNESS OF ROCK HILL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:SCHAFFER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:803-547-4343
Mailing Address - Street 1:739 GALLERIA BLVD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-7818
Mailing Address - Country:US
Mailing Address - Phone:803-547-4343
Mailing Address - Fax:803-547-3914
Practice Address - Street 1:739 GALLERIA BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-7818
Practice Address - Country:US
Practice Address - Phone:803-547-4343
Practice Address - Fax:803-547-3914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-14
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD26568207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty