Lake Marion Primary Care | |
15 E Hospital St Manning SC 29102-3152 | |
(803) 435-2529 | |
(803) 435-4196 |
Full Name | Lake Marion Primary Care |
---|---|
Speciality | Internal Medicine - Cardiovascular Disease |
Location | 15 E Hospital St, Manning, South Carolina |
Authorized Official Name and Position | Saundra Wallace (ADMINISTRATOR) |
Authorized Official Contact | 8034352529 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Lake Marion Primary Care 15 E Hospital St Manning SC 29102-3152 Ph: (803) 435-2529 | Lake Marion Primary Care 15 E Hospital St Manning SC 29102-3152 Ph: (803) 435-2529 |
NPI Number | 1912964479 |
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Provider Enumeration Date | 04/27/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912964479 | NPI | - | NPPES |
GP2178 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 13275 (South Carolina) | Primary |
207RC0000X | Internal Medicine - Cardiovascular Disease | 20345 (South Carolina) | 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 | |