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1010 Devinney Rd York SC 29745-2127 | |
(803) 909-6363 | |
(803) 909-6364 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1010 Devinney Rd, York, South Carolina |
Authorized Official Name and Position | Amy Crysler (CREDENTIALING MANAGER) |
Authorized Official Contact | 8039099751 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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455 Lakeshore Pkwy Rock Hill SC 29730-4205 Ph: (803) 909-6363 | 1010 Devinney Rd York SC 29745-2127 Ph: (803) 909-6363 |
NPI Number | 1124759956 |
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Provider Enumeration Date | 06/22/2022 |
Last Update Date | 09/27/2022 |
Medicare PECOS PAC ID | 9638101272 |
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Medicare Enrollment ID | O20221026003100 |
Identifier | Type | State | Issuer |
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1124759956 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Tri-county Pediatrics Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 815 E Liberty St, York, SC 29745 Phone: 803-329-2700 | |
Pmc Physician Network, L.l.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1795 Devinney Rd, York, SC 29745 Phone: 803-818-5995 Fax: 803-818-5985 | |