Full Name | |
---|---|
Speciality | Family Medicine |
Location | 111 W. Roper Rd., Easley, South Carolina |
Authorized Official Name and Position | Norman Gene Rentz (CEO) |
Authorized Official Contact | 8648784791 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 919 Pickens SC 29671-0919 Ph: (864) 897-8286 | 111 W. Roper Rd. Easley SC 29640 Ph: (864) 897-8280 |
NPI Number | 1760685143 |
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Provider Enumeration Date | 06/06/2007 |
Last Update Date | 07/20/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760685143 | NPI | - | NPPES |
GP4650 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Fleetwood Internal Medicine Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 109b Fleetwood Dr, Easley, SC 29640 Phone: 864-855-1036 Fax: 864-855-3318 | |