| Roman Clinical Consulting, Llc | |
|
917 Broadway St Ste 3 Myrtle Beach SC 29577-3718 | |
| (843) 582-7887 | |
| (843) 800-0061 |
| Full Name | Roman Clinical Consulting, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 917 Broadway St Ste 3, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | John Anthony Roman (OWNER) |
| Authorized Official Contact | 8435827887 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roman Clinical Consulting, Llc 917 Broadway St Ste 3 Myrtle Beach SC 29577-3718 Ph: (843) 582-7887 | Roman Clinical Consulting, Llc 917 Broadway St Ste 3 Myrtle Beach SC 29577-3718 Ph: (843) 582-7887 |
| NPI Number | 1295190734 |
|---|---|
| Provider Enumeration Date | 12/29/2015 |
| Last Update Date | 02/21/2017 |
| Medicare PECOS PAC ID | 9032410501 |
|---|---|
| Medicare Enrollment ID | O20151229001466 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295190734 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 11070 (South Carolina) | Primary |
| Provider Name | John Anthony Roman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073924114 PECOS PAC ID: 7911208483 Enrollment ID: I20151229001603 |
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