| Elizabeth Derks, | |
|
9 Richland Medical Park Dr Ste 110, Columbia, SC 29203-6859 | |
| (803) 434-2505 | |
| (803) 434-2181 |
| Full Name | Elizabeth Derks |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 9 Richland Medical Park Dr Ste 110, Columbia, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912453267 | NPI | - | NPPES |
| 1519 | Other | SC | LICENSED DIETITIAN |
| DT1101 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 1519 (South Carolina) | Primary |
| Provider Name | Eau Claire Cooperative Health Center, Inc. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1346249430 PECOS PAC ID: 3274434220 Enrollment ID: O20040114000335 |
| Provider Name | Musc Community Physicians |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1841878006 PECOS PAC ID: 6507260668 Enrollment ID: O20210811002388 |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth Derks, Po Box 743904, Atlanta, GA 30374-3904 Ph: (803) 296-7320 | Elizabeth Derks, 9 Richland Medical Park Dr Ste 110, Columbia, SC 29203-6859 Ph: (803) 434-2505 |
Tracey Lynn Campbell, MS, RD, LD Dietitian Medicare: Medicare Enrolled Practice Location: 2 Medical Park Rd Ste 107, Columbia, SC 29203 Phone: 803-434-4480 Fax: 803-434-3340 | |
Ms. Rebecca Gilliam Wrenn, MS,RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2727 Preston St, Columbia, SC 29205 Phone: 803-765-1635 | |
Jennifer Barnoud, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1338 Main St Apt 1203, Columbia, SC 29201 Phone: 901-218-4160 | |
Carla Rae Nowicki, RD Dietitian Medicare: Medicare Enrolled Practice Location: 3324 River Dr, Columbia, SC 29201 Phone: 919-412-7746 Fax: 803-296-7330 | |
Rebecca Mcphail Mckenzie, RN, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2000 Hampton St, Columbia, SC 29204 Phone: 803-576-2980 | |
Mrs. Joleen Purpura Alfalahi, RD. LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 5 Richland Medical Park Dr, Columbia, SC 29203 Phone: 803-296-2548 Fax: 803-296-2548 | |
Ms. Mary Robin Mullins, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1924 Main St, Columbia, SC 29201 Phone: 803-434-2300 Fax: 803-254-2611 |