| Carolina Medical Group | |
|
3010 Farrow Rd Suite 230 Columbia SC 29203-7607 | |
| (803) 799-1284 | |
| (803) 799-8148 |
| Full Name | Carolina Medical Group |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 3010 Farrow Rd, Columbia, South Carolina |
| Authorized Official Name and Position | Helen Bryson (CEO) |
| Authorized Official Contact | 8037998407 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Medical Group 1520 Laurel St Columbia SC 29201-2623 Ph: (803) 799-8407 | Carolina Medical Group 3010 Farrow Rd Suite 230 Columbia SC 29203-7607 Ph: (803) 799-1284 |
| NPI Number | 1013939529 |
|---|---|
| Provider Enumeration Date | 07/24/2006 |
| Last Update Date | 04/29/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013939529 | NPI | - | NPPES |
| FQC030 | Medicaid | SC | |
| GP4435 | Medicaid | SC | |
| CBP006 | Medicaid | SC | |
| FQC043 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 20390 (South Carolina) | Primary |
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