Aids Healthcare Foundation | |
4100 N Main St Ste 102 Columbia SC 29203-5800 | |
(803) 223-9895 | |
(803) 735-3641 |
Full Name | Aids Healthcare Foundation |
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Speciality | Internal Medicine |
Location | 4100 N Main St Ste 102, Columbia, South Carolina |
Authorized Official Name and Position | Lyle Honig Mojica (CFO) |
Authorized Official Contact | 3238605305 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Aids Healthcare Foundation 6255 W Sunset Blvd Fl 21 Los Angeles CA 90028-7422 Ph: (323) 860-5200 | Aids Healthcare Foundation 4100 N Main St Ste 102 Columbia SC 29203-5800 Ph: (803) 223-9895 |
NPI Number | 1265784912 |
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Provider Enumeration Date | 10/04/2012 |
Last Update Date | 03/06/2024 |
Medicare PECOS PAC ID | 2668369109 |
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Medicare Enrollment ID | O20180605000845 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265784912 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
Provider Name | Michelle A Rojas |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1205806718 PECOS PAC ID: 9234038787 Enrollment ID: I20040107000376 |
Provider Name | Tonda P Jackson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184690174 PECOS PAC ID: 0244207769 Enrollment ID: I20040914000930 |
Northlake Family Medical Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3000 Ne Medical Park, Ste 101, Columbia, SC 29223 Phone: 803-419-5131 Fax: 803-419-5130 | |
Lagniappe Medical Clinics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 74 Polo Rd, Columbia, SC 29223 Phone: 803-419-7780 Fax: 803-419-7781 | |