OrganizationSprout Pediatrics LlcPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address108 Belfair Rd, Irmo, SC 29063-8040(803) 361-6995PECOS EnrollmentBased on the most recent information from CMS, provider Sprout Pediatrics Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1275899866Provider TypeOrganizationFull NameSprout Pediatrics LlcSubpartNoEnumeration Date4/9/2012Last Updated4/9/2012Contact InformationPractice LocationPractice Address108 Belfair Rd, Irmo, SC 29063-8040Phone(803) 361-6995FaxUnlisted FaxMailing LocationMailing Address108 Belfair Rd, Irmo, SC 29063-8040Phone(803) 361-6995FaxUnlisted FaxAuthorized OfficialNameCoetsee, Rhyno (Administrator)Phone(803) 361-6995Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense2940South Carolina