| Sc Pain & Spine Specialists, Llc | |
|
812 Farrar Dr Suite - B Conway SC 29526-8747 | |
| (843) 839-7246 | |
| (843) 839-7323 |
| Full Name | Sc Pain & Spine Specialists, Llc |
|---|---|
| Speciality | Pain Medicine |
| Location | 812 Farrar Dr, Conway, South Carolina |
| Authorized Official Name and Position | Jason Charles Rosenberg (MEMBER) |
| Authorized Official Contact | 8438397246 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sc Pain & Spine Specialists, Llc Po Box 4057 Pawleys Island SC 29585-4057 Ph: (843) 839-7246 | Sc Pain & Spine Specialists, Llc 812 Farrar Dr Suite - B Conway SC 29526-8747 Ph: (843) 839-7246 |
| NPI Number | 1134544570 |
|---|---|
| Provider Enumeration Date | 02/21/2014 |
| Last Update Date | 03/05/2024 |
| Certification Date | 03/05/2024 |
| Medicare PECOS PAC ID | 4587836275 |
|---|---|
| Medicare Enrollment ID | O20141003000447 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134544570 | NPI | - | NPPES |
| GP5802 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P2900X | Psychiatry & Neurology - Pain Medicine | 24751 (South Carolina) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 24751 (South Carolina) | Primary |
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