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3010 Farrow Rd Carolina Medical Plaza Suite 200 Columbia SC 29203-7607 | |
(803) 434-2741 | |
(803) 434-3175 |
Full Name | |
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Speciality | Family Medicine - Geriatric Medicine |
Location | 3010 Farrow Rd, Columbia, South Carolina |
Authorized Official Name and Position | Darrell C Coven (DIRECTOR, AMBULATORY SERVICES-FINAN) |
Authorized Official Contact | 8032967301 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 402145 Atlanta GA 30384-2145 Ph: (803) 296-7305 | 3010 Farrow Rd Carolina Medical Plaza Suite 200 Columbia SC 29203-7607 Ph: (803) 434-2741 |
NPI Number | 1104188606 |
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Provider Enumeration Date | 06/11/2012 |
Last Update Date | 06/11/2012 |
Identifier | Type | State | Issuer |
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1104188606 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
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 | |