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12 W South St # Ab Manning SC 29102-2925 | |
(803) 433-4321 | |
(803) 433-1207 |
Full Name | |
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Speciality | Clinic/Center |
Location | 12 W South St # Ab, Manning, South Carolina |
Authorized Official Name and Position | Mark Vinson (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 8436560353 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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360 N Irby St Florence SC 29501-2808 Ph: (843) 667-9414 | 12 W South St # Ab Manning SC 29102-2925 Ph: (803) 433-4321 |
NPI Number | 1336480300 |
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Provider Enumeration Date | 03/15/2013 |
Last Update Date | 01/09/2025 |
Medicare PECOS PAC ID | 4082510623 |
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Medicare Enrollment ID | O20130520000133 |
Identifier | Type | State | Issuer |
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1336480300 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Cypress Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1036 Professional Ct, Manning, SC 29102 Phone: 803-433-5220 Fax: 803-433-5221 | |
Hopehealth Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2155 Paxville Hwy, Manning, SC 29102 Phone: 803-433-4321 | |