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21 S Shirley Ave Honea Path SC 29654-1503 | |
(864) 512-7879 | |
(864) 512-7037 |
Full Name | |
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Speciality | Clinic/Center |
Location | 21 S Shirley Ave, Honea Path, South Carolina |
Authorized Official Name and Position | Christine Marie Pearson (VP CFO) |
Authorized Official Contact | 8645121104 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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) 512-7879 |
NPI Number | 1801500459 |
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Provider Enumeration Date | 01/09/2023 |
Last Update Date | 01/16/2023 |
Medicare PECOS PAC ID | 1951215243 |
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Medicare Enrollment ID | O20230313000806 |
Identifier | Type | State | Issuer |
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1801500459 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |