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21 S Shirley Ave Honea Path SC 29654-1503 | |
(864) 369-0552 | |
(864) 369-1826 |
Full Name | |
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Speciality | Family Medicine |
Location | 21 S Shirley Ave, Honea Path, South Carolina |
Authorized Official Name and Position | Christine Pearson (CFO) |
Authorized Official Contact | 8645121109 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 100174 Columbia SC 29202-3174 Ph: (864) 512-7879 | 21 S Shirley Ave Honea Path SC 29654-1503 Ph: (864) 369-0552 |
NPI Number | 1629025010 |
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Provider Enumeration Date | 05/30/2006 |
Last Update Date | 11/21/2022 |
Identifier | Type | State | Issuer |
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1629025010 | NPI | - | NPPES |
CG3298 | Other | RAILROAD MEDICARE | |
GP2684 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |