| Lowcountry Street Grocery | |
|
1108 Wappoo Rd, Charleston, SC 29407-5954 | |
| (843) 609-8188 | |
| Not Available |
| Full Name | Lowcountry Street Grocery |
|---|---|
| Type | Facility |
| Speciality | Dietitian, Registered |
| Location | 1108 Wappoo Rd, Charleston, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568081024 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
| Provider Name | Keely Flynn Hudgins |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1043762743 PECOS PAC ID: 3577843259 Enrollment ID: I20161215001293 |
| Provider Name | Olivia R Myers |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1093112013 PECOS PAC ID: 8325387558 Enrollment ID: I20190305001724 |
| Mailing Address | Practice Location Address |
|---|---|
| Lowcountry Street Grocery 1108 Wappoo Rd, Charleston, SC 29407-5954 Ph: () - | Lowcountry Street Grocery 1108 Wappoo Rd, Charleston, SC 29407-5954 Ph: (843) 609-8188 |
Susanne H Hendricks, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 109 Bee St, Charleston, SC 29401 Phone: 843-577-5011 | |
Mrs. Amy Bilbo, MS, RD, LD, CNSC Dietitian Medicare: Not Enrolled in Medicare Practice Location: 165 Ashley Ave, Msc 905, Charleston, SC 29425 Phone: 843-876-7271 | |
Madison Locke, RDN, LD Dietitian Medicare: Medicare Enrolled Practice Location: 171 Ashley Ave, Charleston, SC 29425 Phone: 843-792-1414 | |
Mrs. Debra Petitpain, MS, LD, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 25 Courtenay Dr, Msc 290, Ste7100a, Charleston, SC 29425 Phone: 843-876-4867 | |
Mrs. Cecilia Kennedy Mcmillan, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 165 Ashley Ave, Suite Eh1108, Charleston, SC 29425 Phone: 843-792-9774 | |
James Peter Klauder, RD, LDN Dietitian Medicare: Medicare Enrolled Practice Location: 171 Ashley Ave, Charleston, SC 29425 Phone: 843-792-9704 | |
Keely Flynn Hudgins, MPH,RD, LD Dietitian Medicare: Medicare Enrolled Practice Location: 2093 Henry Tecklenburg Dr Ste 202e, Charleston, SC 29414 Phone: 843-958-2590 Fax: 843-402-1972 |