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403 Hillcrest Dr Ste E Easley SC 29640-1207 | |
(864) 722-0283 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 403 Hillcrest Dr Ste E, Easley, South Carolina |
Authorized Official Name and Position | Mark John Rajkowski (CEO) |
Authorized Official Contact | 8647220283 |
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 311 Clemson SC 29633-0311 Ph: (864) 722-0283 | 403 Hillcrest Dr Ste E Easley SC 29640-1207 Ph: (864) 722-0283 |
NPI Number | 1083169213 |
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Provider Enumeration Date | 08/17/2016 |
Last Update Date | 03/26/2020 |
Medicare PECOS PAC ID | 8628227667 |
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Medicare Enrollment ID | O20170310002094 |
Identifier | Type | State | Issuer |
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1083169213 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Fleetwood Internal Medicine Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 109b Fleetwood Dr, Easley, SC 29640 Phone: 864-855-1036 Fax: 864-855-3318 | |