Hope Clinic Llc | |
110 Executive Pkwy Moncks Corner SC 29461-3930 | |
(843) 899-9099 | |
(888) 318-5567 |
Full Name | Hope Clinic Llc |
---|---|
Speciality | Internal Medicine |
Location | 110 Executive Pkwy, Moncks Corner, South Carolina |
Authorized Official Name and Position | Asante Wagner (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 8434084171 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Hope Clinic Llc 110 Executive Pkwy Moncks Corner SC 29461-3930 Ph: (843) 408-4171 | Hope Clinic Llc 110 Executive Pkwy Moncks Corner SC 29461-3930 Ph: (843) 899-9099 |
NPI Number | 1144299470 |
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Provider Enumeration Date | 03/17/2006 |
Last Update Date | 06/09/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144299470 | NPI | - | NPPES |
202346 | Medicaid | SC | |
4225947 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER | |
GP3438 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 20234 (South Carolina) | Primary |
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