Providence Physician Practices Llc is a
Internal Medicine based in Kershaw, South Carolina. Providence Physician Practices Llc is licensed to practice in * (Not Available) (license number ) and their current practice location is
216 E Marion St, Kershaw, South Carolina. It can be reached at their office (for appointments etc.) via phone at
(803) 475-3350.
NPI number for Providence Physician Practices Llc is 1659921740 and their current mailing address is 330 Seven Springs Way, Brentwood, Tennessee. Providence Physician Practices Llc
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1659921740.
Healthcare Provider's Profile
| Full Name | Providence Physician Practices Llc |
|---|
| Type | Facility |
|---|
| Speciality | Internal Medicine |
|---|
| Location | 216 E Marion St, Kershaw, South Carolina |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1659921740
- Provider Enumeration Date: 09/19/2019
- Last Update Date: 12/09/2019
Medical Identifiers
Medical identifiers for Providence Physician Practices Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1659921740 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | (* (Not Available)) | Secondary |
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Secondary |
| 207V00000X | Obstetrics & Gynecology | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| 363LG0600X | Nurse Practitioner - Gerontology | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Providence Physician Practices Llc is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Providence Physician Practices Llc
330 Seven Springs Way,
Brentwood, TN 37027-5098
Ph: (615) 920-7782 | Providence Physician Practices Llc
216 E Marion St,
Kershaw, SC 29067-1442
Ph: (803) 475-3350 |
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