Carolina Healthchoice Of Columbia, Llc | |
1494 Lake Murray Blvd Columbia SC 29212-8697 | |
(803) 764-0464 | |
(803) 764-3126 |
Full Name | Carolina Healthchoice Of Columbia, Llc |
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Speciality | General Practice |
Location | 1494 Lake Murray Blvd, Columbia, South Carolina |
Authorized Official Name and Position | Charles Sloan (CFO) |
Authorized Official Contact | 8037640464 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Carolina Healthchoice Of Columbia, Llc 1494 Lake Murray Blvd Columbia SC 29212-8697 Ph: (803) 764-0464 | Carolina Healthchoice Of Columbia, Llc 1494 Lake Murray Blvd Columbia SC 29212-8697 Ph: (803) 764-0464 |
NPI Number | 1922511658 |
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Provider Enumeration Date | 11/16/2017 |
Last Update Date | 12/19/2018 |
Medicare PECOS PAC ID | 7113289893 |
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Medicare Enrollment ID | O20180316000048 |
Identifier | Type | State | Issuer |
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1922511658 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
208VP0014X | Pain Medicine - Interventional Pain Medicine | (* (Not Available)) | Secondary |
Provider Name | Lorone Cowayne Washington |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1174628077 PECOS PAC ID: 8921047515 Enrollment ID: I20050906000318 |
Provider Name | Jennifer M Paglia |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356530497 PECOS PAC ID: 6103915921 Enrollment ID: I20071203000020 |
Provider Name | Regina B Rouse |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487938825 PECOS PAC ID: 0042484974 Enrollment ID: I20111110000762 |
Provider Name | Jon Kennon Peters |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720320740 PECOS PAC ID: 2860626470 Enrollment ID: I20131015001627 |
Provider Name | Veronica Stevenson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093248551 PECOS PAC ID: 4082003546 Enrollment ID: I20211123000608 |
Northlake Family Medical Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3000 Ne Medical Park, Ste 101, Columbia, SC 29223 Phone: 803-419-5131 Fax: 803-419-5130 | |
Lagniappe Medical Clinics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 74 Polo Rd, Columbia, SC 29223 Phone: 803-419-7780 Fax: 803-419-7781 | |