| |
104 Liner Drive Greenwood SC 29646 | |
(864) 227-1115 | |
(864) 227-2046 |
Full Name | |
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Speciality | Internal Medicine |
Location | 104 Liner Drive, Greenwood, South Carolina |
Authorized Official Name and Position | Matthew T Logan (PRESIDENT AND CHIEF EXECUTIVE OFFIC) |
Authorized Official Contact | 8647254253 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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104 Liner Drive Greenwood SC 29646 Ph: (864) 227-1115 | 104 Liner Drive Greenwood SC 29646 Ph: (864) 227-1115 |
NPI Number | 1588969448 |
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Provider Enumeration Date | 01/24/2011 |
Last Update Date | 12/14/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588969448 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
Carolina Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 313 Main St, Greenwood, SC 29646 Phone: 864-396-0117 Fax: 864-388-0648 | |
Hands Of Hope Children's Therapy Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 Maxwell Ave, Greenwood, SC 29646 Phone: 864-993-3302 |