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605 W Palmetto St Florence SC 29501-4301 | |
| (843) 942-9960 | |
| (843) 799-5088 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 605 W Palmetto St, Florence, South Carolina |
| Authorized Official Name and Position | George Maxie Harrison (OWNER) |
| Authorized Official Contact | 8439429960 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1209 Central Rd Olanta SC 29114-9773 Ph: (843) 616-3410 | 605 W Palmetto St Florence SC 29501-4301 Ph: (843) 942-9960 |
| NPI Number | 1891317228 |
|---|---|
| Provider Enumeration Date | 05/07/2020 |
| Last Update Date | 12/13/2024 |
| Certification Date | 12/13/2024 |
| Medicare PECOS PAC ID | 9032599410 |
|---|---|
| Medicare Enrollment ID | O20220701000085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891317228 | NPI | - | NPPES |
| GP9651 | Medicaid | SC |
| Provider Name | George Maxie Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336590306 PECOS PAC ID: 0446539027 Enrollment ID: I20161123000555 |
| Provider Name | Aran Colleen Ingham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265208185 PECOS PAC ID: 3577008218 Enrollment ID: I20240717002532 |
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