| Caresouth Carolina Inc | |
|
122 Latimer St Latta SC 29565-1828 | |
| (843) 857-0111 | |
| Not Available |
| Full Name | Caresouth Carolina Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 122 Latimer St, Latta, 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 122 Latimer St Latta SC 29565-1828 Ph: () - | Caresouth Carolina Inc 122 Latimer St Latta SC 29565-1828 Ph: (843) 857-0111 |
| NPI Number | 1972980621 |
|---|---|
| Provider Enumeration Date | 05/01/2015 |
| Last Update Date | 06/15/2016 |
| Medicare PECOS PAC ID | 1052221314 |
|---|---|
| Medicare Enrollment ID | O20160225002736 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972980621 | NPI | - | NPPES |
| FQC197 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Marion Medical Group-latta Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 108a E Main St, Latta, SC 29565 Phone: 843-752-1234 Fax: 843-752-1108 | |
Mcleod Family Medicine - Latta Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 108a East Main Street, Latta, SC 29565 Phone: 843-752-5111 Fax: 843-752-5100 |