| Brookland Community Pediatrics | |
|
500 N 12th St West Columbia SC 29169-6502 | |
| (803) 217-0415 | |
| (803) 939-1650 |
| Full Name | Brookland Community Pediatrics |
|---|---|
| Speciality | Clinic/Center |
| Location | 500 N 12th St, West Columbia, South Carolina |
| Authorized Official Name and Position | Delgado Cantave (CEO) |
| Authorized Official Contact | 8037335969 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookland Community Pediatrics Po Box 3788 Columbia SC 29230-3788 Ph: (803) 733-5969 | Brookland Community Pediatrics 500 N 12th St West Columbia SC 29169-6502 Ph: (803) 217-0415 |
| NPI Number | 1629381678 |
|---|---|
| Provider Enumeration Date | 07/20/2010 |
| Last Update Date | 02/03/2022 |
| Medicare PECOS PAC ID | 3274434220 |
|---|---|
| Medicare Enrollment ID | O20121030000255 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629381678 | NPI | - | NPPES |
| 421843 | Other | SC | GROUP PTAN |
| FQC031 | Medicaid | SC | |
| FQC151 | Medicaid | SC | |
| CBP018 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Lexington Hospitalists Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2720 Sunset Blvd, West Columbia, SC 29169 Phone: 803-791-2480 Fax: 803-936-4102 | |
Jay M Markowitz Md & Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Saluda Ridge Ct, West Columbia, SC 29169 Phone: 803-794-3320 Fax: 803-794-3157 | |
Senior Health Associates, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2858 Sunset Blvd, West Columbia, SC 29169 Phone: 803-699-9073 Fax: 866-527-0937 | |
Lexington Weight Management Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2728 Sunset Blvd Ste 303, West Columbia, SC 29169 Phone: 803-936-7505 | |
Intramed Plus Infusion & Medical Center, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 112 Saluda Ridge Ct Ste 200, West Columbia, SC 29169 Phone: 803-794-0200 Fax: 803-794-0404 | |
Lexington Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 East Medical Lane, West Columbia, SC 29169 Phone: 803-936-7210 Fax: 803-736-8854 | |
Select Physicians Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Still Hopes Dr, West Columbia, SC 29169 Phone: 803-796-6490 |