Full Name | |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 9063 Sunrise Rd, Smoaks, South Carolina |
Authorized Official Name and Position | Aretha Jones (CEO) |
Authorized Official Contact | 8437224112 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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51 Nassau St Charleston SC 29403-5513 Ph: (843) 722-4112 | 9063 Sunrise Rd Smoaks SC 29481 Ph: (843) 722-4112 |
NPI Number | 1992256689 |
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Provider Enumeration Date | 10/18/2016 |
Last Update Date | 10/18/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992256689 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |