Angel Oak Family Medicine Llc | |
1816 Bohicket Rd Ste F Johns Island SC 29455-3318 | |
(843) 559-1938 | |
Not Available |
Full Name | Angel Oak Family Medicine Llc |
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Speciality | Clinic/Center |
Location | 1816 Bohicket Rd Ste F, Johns Island, South Carolina |
Authorized Official Name and Position | Jacqueline Leonara Baer (PROVIDER) |
Authorized Official Contact | 8435591938 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Angel Oak Family Medicine Llc Po Box 336 Johns Island SC 29457-0336 Ph: (843) 559-1938 | Angel Oak Family Medicine Llc 1816 Bohicket Rd Ste F Johns Island SC 29455-3318 Ph: (843) 559-1938 |
NPI Number | 1902083058 |
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Provider Enumeration Date | 01/30/2008 |
Last Update Date | 12/06/2012 |
Medicare PECOS PAC ID | 8426098708 |
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Medicare Enrollment ID | O20050505000737 |
Identifier | Type | State | Issuer |
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1902083058 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | RHC153 (South Carolina) | Primary |
South Carolina Integrative Health Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1807 Crowne Commons Way Ste F8, Johns Island, SC 29455 Phone: 843-806-9402 | |