| Leigh Bostic Llc | |
|
110 Manly St Greenville SC 29601-3025 | |
| (864) 298-8026 | |
| (864) 298-8032 |
| Full Name | Leigh Bostic Llc |
|---|---|
| Speciality | Social Worker |
| Location | 110 Manly St, Greenville, South Carolina |
| Authorized Official Name and Position | Leigh Bostic (SOLE MEMBER) |
| Authorized Official Contact | 8642988026 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leigh Bostic Llc 706 S Almond Dr Simpsonville SC 29681-3347 Ph: (864) 430-0475 | Leigh Bostic Llc 110 Manly St Greenville SC 29601-3025 Ph: (864) 298-8026 |
| NPI Number | 1922487321 |
|---|---|
| Provider Enumeration Date | 05/19/2015 |
| Last Update Date | 05/19/2015 |
| Medicare PECOS PAC ID | 3971824327 |
|---|---|
| Medicare Enrollment ID | O20150610001651 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922487321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 5459 (South Carolina) | Primary |
| Provider Name | Leigh F Bostic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518007806 PECOS PAC ID: 0941521306 Enrollment ID: I20150610001772 |
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