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338 E Columbia Ave Batesburg-leesville SC 29070 | |
(803) 604-0066 | |
(803) 604-9924 |
Full Name | |
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Speciality | Clinic/center |
Location | 338 E Columbia Ave, Batesburg-leesville, South Carolina |
Authorized Official Name and Position | Melinda P Kruzner (SR. VP & CFO) |
Authorized Official Contact | 8037912000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 896239 Charlotte NC 28289-6239 Ph: (803) 604-0066 | 338 E Columbia Ave Batesburg-leesville SC 29070 Ph: (803) 604-0066 |
NPI Number | 1932127883 |
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Provider Enumeration Date | 07/18/2006 |
Last Update Date | 08/10/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932127883 | NPI | - | NPPES |
GP1258 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |