437 Medical Group / Cafb | |
204 W Hill Blvd Charleston Afb SC 29404-4704 | |
(843) 963-6936 | |
(843) 963-6903 |
Full Name | 437 Medical Group / Cafb |
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Speciality | Clinic/center |
Location | 204 W Hill Blvd, Charleston Afb, South Carolina |
Authorized Official Name and Position | Ronnie Lee Godbolt (INDEPENDENT DUTY MEDICAL TECHNICIAN) |
Authorized Official Contact | 8439636936 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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437 Medical Group / Cafb 204 W Hill Blvd Charleston Afb SC 29404-4704 Ph: (843) 963-6936 | 437 Medical Group / Cafb 204 W Hill Blvd Charleston Afb SC 29404-4704 Ph: (843) 963-6936 |
NPI Number | 1023246659 |
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Provider Enumeration Date | 06/22/2009 |
Last Update Date | 06/22/2009 |
Identifier | Type | State | Issuer |
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1023246659 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |