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722 Hyatt St Ste C Gaffney SC 29341-2644 | |
(864) 487-2400 | |
(864) 488-3987 |
Full Name | |
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Speciality | Clinic/Center |
Location | 722 Hyatt St Ste C, Gaffney, South Carolina |
Authorized Official Name and Position | Kenneth Meinke (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 8645606000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 277723 Atlanta GA 30384-7723 Ph: (864) 560-6000 | 722 Hyatt St Ste C Gaffney SC 29341-2644 Ph: (864) 487-2400 |
NPI Number | 1376184499 |
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Provider Enumeration Date | 09/30/2019 |
Last Update Date | 03/23/2022 |
Medicare PECOS PAC ID | 5991041212 |
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Medicare Enrollment ID | O20210726000482 |
Identifier | Type | State | Issuer |
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1376184499 | NPI | - | NPPES |
42-3493 | Other | SC | MEDICARE PIN |
RHC269 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Cherokee Community Care, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1307 N Logan St, Gaffney, SC 29341 Phone: 864-488-1333 | |