| Elizabeth Corbett, Llc | |
|
1612 Marion St Suite 311 Columbia SC 29201-2939 | |
| (803) 361-7940 | |
| (803) 695-4935 |
| Full Name | Elizabeth Corbett, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1612 Marion St, Columbia, South Carolina |
| Authorized Official Name and Position | Elizabeth Ann Corbett (OWNER) |
| Authorized Official Contact | 8033617940 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth Corbett, Llc 105 Lazy Acres Dr Columbia SC 29209-4255 Ph: (803) 361-7940 | Elizabeth Corbett, Llc 1612 Marion St Suite 311 Columbia SC 29201-2939 Ph: (803) 361-7940 |
| NPI Number | 1114322625 |
|---|---|
| Provider Enumeration Date | 10/27/2014 |
| Last Update Date | 10/27/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114322625 | NPI | - | NPPES |
| SW1153 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 4991 (South Carolina) | Primary |
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