| Carolina Pediatric Associates | |
|
301 W Pine St Blacksburg SC 29702-1549 | |
| (864) 839-4325 | |
| (864) 839-9901 |
| Full Name | Carolina Pediatric Associates |
|---|---|
| Speciality | Clinic/Center |
| Location | 301 W Pine St, Blacksburg, South Carolina |
| Authorized Official Name and Position | Daren Edward Carling (OWNER) |
| Authorized Official Contact | 8648394325 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Pediatric Associates 301 W Pine St Blacksburg SC 29702-1549 Ph: (864) 839-4325 | Carolina Pediatric Associates 301 W Pine St Blacksburg SC 29702-1549 Ph: (864) 839-4325 |
| NPI Number | 1730233172 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 02/25/2009 |
| Medicare PECOS PAC ID | 2062442940 |
|---|---|
| Medicare Enrollment ID | O20050819000744 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730233172 | NPI | - | NPPES |
| RHC159 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 23503 (South Carolina) | Primary |
Novant Health Blacksburg Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 303 W Pine St, Suite B, Blacksburg, SC 29702 Phone: 864-839-3082 Fax: 864-839-3064 |