| Caresouth Carolina, Inc | |
|
1016 Old Latta Hwy Dillon SC 29536-2557 | |
| (843) 774-4337 | |
| Not Available |
| Full Name | Caresouth Carolina, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1016 Old Latta Hwy, Dillon, South Carolina |
| Authorized Official Name and Position | Ann M 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: (843) 857-0111 | Caresouth Carolina, Inc 1016 Old Latta Hwy Dillon SC 29536-2557 Ph: (843) 774-4337 |
| NPI Number | 1255762936 |
|---|---|
| Provider Enumeration Date | 12/06/2013 |
| Last Update Date | 06/09/2022 |
| Medicare PECOS PAC ID | 1052221314 |
|---|---|
| Medicare Enrollment ID | O20141024002045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255762936 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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