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7035 Saint Andrews Rd Columbia SC 29212 | |
(803) 358-6160 | |
(803) 407-4101 |
Full Name | |
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Speciality | Clinic/center - Radiology |
Location | 7035 Saint Andrews Rd, Columbia, South Carolina |
Authorized Official Name and Position | Melinda Sarvis (EXECUTIVE VP) |
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) 358-6160 | 7035 Saint Andrews Rd Columbia SC 29212 Ph: (803) 358-6160 |
NPI Number | 1811922164 |
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Provider Enumeration Date | 07/12/2006 |
Last Update Date | 09/18/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811922164 | NPI | - | NPPES |
SL0023 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
261QR0200X | Clinic/center - Radiology | (* (Not Available)) | Primary |
Northlake Family Medical Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3000 Ne Medical Park, Ste 101, Columbia, SC 29223 Phone: 803-419-5131 Fax: 803-419-5130 | |
Lagniappe Medical Clinics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 74 Polo Rd, Columbia, SC 29223 Phone: 803-419-7780 Fax: 803-419-7781 | |