| Caresouth Carolina, Inc | |
|
812 State Rd Cheraw SC 29520-7113 | |
| (843) 537-0961 | |
| Not Available |
| Full Name | Caresouth Carolina, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 812 State Rd, Cheraw, South Carolina |
| Authorized Official Name and Position | Ann Lewis (CEO) |
| Authorized Official Contact | 8438570111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caresouth Carolina, Inc Po Box 1090 Hartsville SC 29551-1090 Ph: () - | Caresouth Carolina, Inc 812 State Rd Cheraw SC 29520-7113 Ph: (843) 537-0961 |
| NPI Number | 1285677443 |
|---|---|
| Provider Enumeration Date | 06/14/2006 |
| Last Update Date | 03/11/2024 |
| Medicare PECOS PAC ID | 1052221314 |
|---|---|
| Medicare Enrollment ID | O20100526000204 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285677443 | NPI | - | NPPES |
| FQC013 | Medicaid | SC | |
| CBP012 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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