| |
880 West Moultrie Street Suite 3 Winnsboro SC 29180-2411 | |
(803) 635-0288 | |
(803) 635-0262 |
Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 880 West Moultrie Street, Winnsboro, South Carolina |
Authorized Official Name and Position | Michael L. Williams (ADMINISTRATOR) |
Authorized Official Contact | 8036350233 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
P.o. Box 620 Winnsboro SC 29180-0620 Ph: (803) 635-0288 | 880 West Moultrie Street Suite 3 Winnsboro SC 29180-2411 Ph: (803) 635-0288 |
NPI Number | 1992018691 |
---|---|
Provider Enumeration Date | 07/22/2010 |
Last Update Date | 07/22/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992018691 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | HTL-154 (South Carolina) | Primary |
Fairfield Medical Associates, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 880 West Moultrie St., Suite 200, Winnsboro, SC 29180 Phone: 803-635-6487 Fax: 803-635-6089 | |