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22 Gardener Rd Box 247 Blackville SC 29817-0247 | |
(803) 284-2041 | |
(803) 284-5516 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 22 Gardener Rd, Blackville, South Carolina |
Authorized Official Name and Position | Charlie Clifton Alsbrooks (ADMINISTRATOR) |
Authorized Official Contact | 8036416277 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 247 22 Gardener Road Blackville SC 29817-0247 Ph: (803) 284-2041 | 22 Gardener Rd Box 247 Blackville SC 29817-0247 Ph: (803) 284-2041 |
NPI Number | 1699808006 |
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Provider Enumeration Date | 03/14/2007 |
Last Update Date | 07/12/2007 |
Identifier | Type | State | Issuer |
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1699808006 | NPI | - | NPPES |
RHC005 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | 08504 (South Carolina) | Primary |
Low Country Health Care System Mobile Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 Baker St N, Blackville, SC 29817 Phone: 803-284-1045 | |