| Amethyst Health, Llc | |
|
1175 Grey Pine Dr Blythewood SC 29016-7320 | |
| (717) 880-3740 | |
| Not Available |
| Full Name | Amethyst Health, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1175 Grey Pine Dr, Blythewood, South Carolina |
| Authorized Official Name and Position | Wachovia Chanta' Banks (FAMILY MEDICINE PHYSICIAN) |
| Authorized Official Contact | 7178803740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amethyst Health, Llc 1175 Grey Pine Dr Blythewood SC 29016-7320 Ph: (717) 880-3740 | Amethyst Health, Llc 1175 Grey Pine Dr Blythewood SC 29016-7320 Ph: (717) 880-3740 |
| NPI Number | 1407475676 |
|---|---|
| Provider Enumeration Date | 04/08/2020 |
| Last Update Date | 04/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407475676 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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