| Tanner Healthcare Services, Llc | |
|
546 Long Pine Drive Bythewood SC 29016 | |
| (302) 399-6509 | |
| (803) 708-3743 |
| Full Name | Tanner Healthcare Services, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 546 Long Pine Drive, Bythewood, South Carolina |
| Authorized Official Name and Position | Susan Tanner (OWNER) |
| Authorized Official Contact | 3023996509 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tanner Healthcare Services, Llc 546 Long Pine Dr Blythewood SC 29016-7298 Ph: (302) 399-6509 | Tanner Healthcare Services, Llc 546 Long Pine Drive Bythewood SC 29016 Ph: (302) 399-6509 |
| NPI Number | 1083224240 |
|---|---|
| Provider Enumeration Date | 08/03/2020 |
| Last Update Date | 09/06/2023 |
| Certification Date | 12/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083224240 | NPI | - | NPPES |
| NP4870 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |