| Lake Ridge Family Medicine | |
|
557 Columbia Avenue Suite D Chapin SC 29036 | |
| (803) 345-1288 | |
| (803) 345-1623 |
| Full Name | Lake Ridge Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 557 Columbia Avenue, Chapin, South Carolina |
| Authorized Official Name and Position | Melinda P Kruzner (CFO & SR. VP) |
| Authorized Official Contact | 8037912000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Ridge Family Medicine 557 Columbia Avenue Suite D Chapin SC 29036 Ph: (803) 345-1288 | Lake Ridge Family Medicine 557 Columbia Avenue Suite D Chapin SC 29036 Ph: (803) 345-1288 |
| NPI Number | 1992739015 |
|---|---|
| Provider Enumeration Date | 07/11/2006 |
| Last Update Date | 06/01/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992739015 | NPI | - | NPPES |
| GP4194 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Chapin Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1612 Chapin Rd, Chapin, SC 29036 Phone: 803-345-3414 | |
Chapin Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1612 Chapin Road, Chapin, SC 29036 Phone: 803-345-3414 Fax: 803-345-1672 | |
Palmetto Homecare Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 221 Massey Cir, Chapin, SC 29036 Phone: 803-391-2755 |