| Mojo Therapeutics Llc | |
|
135 E Main St Ste 213 Rock Hill SC 29730-4892 | |
| (803) 579-8558 | |
| (844) 440-1981 |
| Full Name | Mojo Therapeutics Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 135 E Main St Ste 213, Rock Hill, South Carolina |
| Authorized Official Name and Position | Alicia D. Muldrow (OWNER) |
| Authorized Official Contact | 8035798558 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mojo Therapeutics Llc 135 E Main St Ste 213 Rock Hill SC 29730-4892 Ph: (803) 579-8558 | Mojo Therapeutics Llc 135 E Main St Ste 213 Rock Hill SC 29730-4892 Ph: (803) 579-8558 |
| NPI Number | 1295470904 |
|---|---|
| Provider Enumeration Date | 04/28/2022 |
| Last Update Date | 08/03/2023 |
| Certification Date | 08/03/2023 |
| Medicare PECOS PAC ID | 0446632285 |
|---|---|
| Medicare Enrollment ID | O20220727000184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295470904 | NPI | - | NPPES |
| LW1076 | Medicaid | SC |
| Provider Name | Alicia Muldrow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740883891 PECOS PAC ID: 1355723198 Enrollment ID: I20220727000238 |
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