| Little Mountain Pediatrics And Family Practice | |
|
99 N Mill St Little Mountain SC 29075-8788 | |
| (803) 945-1005 | |
| Not Available |
| Full Name | Little Mountain Pediatrics And Family Practice |
|---|---|
| Speciality | Clinic/Center |
| Location | 99 N Mill St, Little Mountain, South Carolina |
| Authorized Official Name and Position | Delgado Cantave (CEO) |
| Authorized Official Contact | 8037335969 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Little Mountain Pediatrics And Family Practice Po Box 3788 Columbia SC 29230-3788 Ph: (803) 733-5969 | Little Mountain Pediatrics And Family Practice 99 N Mill St Little Mountain SC 29075-8788 Ph: (803) 945-1005 |
| NPI Number | 1669029294 |
|---|---|
| Provider Enumeration Date | 08/19/2019 |
| Last Update Date | 09/01/2020 |
| Medicare PECOS PAC ID | 3274434220 |
|---|---|
| Medicare Enrollment ID | O20190910003811 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669029294 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Little Mountain Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 99 N Mill St, Little Mountain, SC 29075 Phone: 803-945-1005 | |
Newberry Family Heatlh Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 99 N Mill St, Little Mountain, SC 29075 Phone: 803-945-1005 |