| Plexus Health | |
|
703 N White St Lancaster SC 29720-2174 | |
| (803) 285-2273 | |
| (803) 459-1547 |
| Full Name | Plexus Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 703 N White St, Lancaster, South Carolina |
| Authorized Official Name and Position | Randall Stewart Barre (CEO) |
| Authorized Official Contact | 8034653608 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Plexus Health 212 E Marion St Kershaw SC 29067-1442 Ph: (803) 465-3608 | Plexus Health 703 N White St Lancaster SC 29720-2174 Ph: (803) 285-2273 |
| NPI Number | 1154510352 |
|---|---|
| Provider Enumeration Date | 10/24/2007 |
| Last Update Date | 02/24/2024 |
| Medicare PECOS PAC ID | 4789766932 |
|---|---|
| Medicare Enrollment ID | O20080128000519 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154510352 | NPI | - | NPPES |
| 421967 | Other | SC | MEDICARE PART A |
| FQC145 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (South Carolina) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Teresa G Ormand |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437220522 PECOS PAC ID: 7618907528 Enrollment ID: I20050819000173 |
| Provider Name | Randall Stewart Barre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316261258 PECOS PAC ID: 5799900569 Enrollment ID: I20140919001781 |
| Provider Name | Hloy Tenora Green |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437444155 PECOS PAC ID: 2466617725 Enrollment ID: I20141208000033 |
| Provider Name | Mary Camille Hiott Nutter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528265998 PECOS PAC ID: 2365756749 Enrollment ID: I20150729007960 |
| Provider Name | Denise Marie Wolfe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568177004 PECOS PAC ID: 6507231917 Enrollment ID: I20230417000425 |
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