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86 N Main St Greeleyville SC 29056-9374 | |
(843) 426-2180 | |
(843) 426-2182 |
Full Name | |
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Speciality | Family Medicine |
Location | 86 N Main St, Greeleyville, South Carolina |
Authorized Official Name and Position | Leslie Freeman (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 8034331216 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 578 Manning SC 29102-0578 Ph: (803) 433-1216 | 86 N Main St Greeleyville SC 29056-9374 Ph: (843) 426-2180 |
NPI Number | 1558308965 |
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Provider Enumeration Date | 06/02/2006 |
Last Update Date | 04/08/2008 |
Identifier | Type | State | Issuer |
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1558308965 | NPI | - | NPPES |
4399 | Other | SC | MEDICARE PART B |