Lorenzo Sentell Black, | |
300 W Front St, Liberty, SC 29657-1012 | |
(864) 843-5605 | |
(864) 843-0996 |
Full Name | Lorenzo Sentell Black |
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Gender | Male |
Speciality | Nurse Practitioner - Family |
Location | 300 W Front St, Liberty, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1548886062 | NPI | - | NPPES |
NP7292 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 228658 (South Carolina) | Secondary |
363LF0000X | Nurse Practitioner - Family | 24339 (South Carolina) | Primary |
Entity Name | Medcare Express - North Charleston Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457579617 PECOS PAC ID: 7618074899 Enrollment ID: O20070523000200 |
Entity Name | Unity Health On Main |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326401217 PECOS PAC ID: 7810264900 Enrollment ID: O20170519001772 |
Mailing Address | Practice Location Address |
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Lorenzo Sentell Black, 300 E Mcbee Ave Fl 4, Greenville, SC 29601-2842 Ph: () - | Lorenzo Sentell Black, 300 W Front St, Liberty, SC 29657-1012 Ph: (864) 843-5605 |
Augusta B Hall, FNP - C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 105 Liberty Blvd, Liberty, SC 29657 Phone: 864-843-9213 Fax: 864-843-5634 | |
Mrs. Sandra Sleeman Franklin, F.N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 300 W Front St, Liberty, SC 29657 Phone: 864-843-5605 Fax: 864-843-0996 | |
Stacy Browder, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 300 W Front St, Liberty, SC 29657 Phone: 864-843-5605 Fax: 864-843-0996 | |
Kathryn Juanita Morrow, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 300 W Front St, Liberty, SC 29657 Phone: 864-843-5602 | |
Ruth Ann Geide, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 300 W Front St, Liberty, SC 29657 Phone: 864-843-5605 Fax: 864-843-0996 |