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169 Hall St Spartanburg SC 29302-1523 | |
(864) 542-9966 | |
(864) 542-9977 |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 169 Hall St, Spartanburg, South Carolina |
Authorized Official Name and Position | Therion Langford Moore (OFFICE MANAGER) |
Authorized Official Contact | 8645429966 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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169 Hall St Spartanburg SC 29302-1523 Ph: (864) 542-9966 | 169 Hall St Spartanburg SC 29302-1523 Ph: (864) 542-9966 |
NPI Number | 1194850669 |
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Provider Enumeration Date | 02/23/2007 |
Last Update Date | 06/24/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194850669 | NPI | - | NPPES |
236355 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 23635 (South Carolina) | Primary |
Academic Primary Care Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Magnolia St, Spartanburg, SC 29303 Phone: 540-443-7180 | |