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3627 Maybank Hwy Johns Island SC 29455-4825 | |
(843) 628-0284 | |
(843) 559-9912 |
Full Name | |
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Speciality | Clinic/Center |
Location | 3627 Maybank Hwy, Johns Island, South Carolina |
Authorized Official Name and Position | Aretha Jones (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 8437224112 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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51 Nassau Street Charleston SC 29403-5513 Ph: (843) 722-4112 | 3627 Maybank Hwy Johns Island SC 29455-4825 Ph: (843) 628-0284 |
NPI Number | 1851466726 |
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Provider Enumeration Date | 11/22/2006 |
Last Update Date | 10/18/2016 |
Medicare PECOS PAC ID | 9032215199 |
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Medicare Enrollment ID | O20080819000399 |
Identifier | Type | State | Issuer |
---|---|---|---|
1851466726 | NPI | - | NPPES |
FQC047 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
South Carolina Integrative Health Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1807 Crowne Commons Way Ste F8, Johns Island, SC 29455 Phone: 843-806-9402 | |