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1770 Skylyn Dr Spartanburg SC 29307-1045 | |
(864) 582-7200 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 1770 Skylyn Dr, Spartanburg, South Carolina |
Authorized Official Name and Position | Debbie Brewer (DIRECTOR OF PROVIDER ENROLLMENT) |
Authorized Official Contact | 6154657000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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138 Dillon Dr Ste A Spartanburg SC 29307-1018 Ph: (864) 542-8980 | 1770 Skylyn Dr Spartanburg SC 29307-1045 Ph: (864) 582-7200 |
NPI Number | 1134137581 |
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Provider Enumeration Date | 08/03/2006 |
Last Update Date | 08/14/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134137581 | NPI | - | NPPES |
GP1605 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
Academic Primary Care Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Magnolia St, Spartanburg, SC 29303 Phone: 540-443-7180 | |