| Apexcare Pa | |
|
1165 Highway 1 S Suite 200 Lugoff SC 29078-8966 | |
| (803) 408-0225 | |
| (803) 408-0729 |
| Full Name | Apexcare Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1165 Highway 1 S, Lugoff, South Carolina |
| Authorized Official Name and Position | Olajide A. Balogun (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8034080225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Apexcare Pa 1165 Highway 1 S Suite 200 Lugoff SC 29078-8966 Ph: (803) 408-0225 | Apexcare Pa 1165 Highway 1 S Suite 200 Lugoff SC 29078-8966 Ph: (803) 408-0225 |
| NPI Number | 1508958216 |
|---|---|
| Provider Enumeration Date | 09/29/2006 |
| Last Update Date | 03/10/2011 |
| Medicare PECOS PAC ID | 2466451299 |
|---|---|
| Medicare Enrollment ID | O20061205000469 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508958216 | NPI | - | NPPES |
| 203817 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 20381 (South Carolina) | Primary |
| 208000000X | Pediatrics | 20381 (South Carolina) | Secondary |
| Provider Name | Olajide A Balogun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215997820 PECOS PAC ID: 2466497920 Enrollment ID: I20050627000009 |
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