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187 Bunch Ford Road Holly Hill SC 29059 | |
| (803) 496-3312 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 187 Bunch Ford Road, Holly Hill, South Carolina |
| Authorized Official Name and Position | Lisa M Goodlett (C.O.O) |
| Authorized Official Contact | 8033952462 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 188 Holly Hill SC 29059-0188 Ph: (803) 395-4480 | 187 Bunch Ford Road Holly Hill SC 29059 Ph: (803) 496-3312 |
| NPI Number | 1952350142 |
|---|---|
| Provider Enumeration Date | 05/08/2006 |
| Last Update Date | 04/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952350142 | NPI | - | NPPES |
| GP2353 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Musc Community Physicians Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 187 Bunch Ford Rd, Holly Hill, SC 29059 Phone: 843-792-1414 | |
Family Diagnostic Associates, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 922 Holly St., Holly Hill, SC 29059 Phone: 803-496-7174 Fax: 803-496-7928 | |
Family Diagnostics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 922 Holly St, Holly Hill, SC 29059 Phone: 803-496-7174 Fax: 803-496-7928 |