| |
3973 Rivers Ave N Charleston SC 29405-7058 | |
(843) 722-4112 | |
(843) 722-4802 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 3973 Rivers Ave, N Charleston, South Carolina |
Authorized Official Name and Position | Aretha R Jones (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 8437224112 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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51 Nassau St Charleston SC 29403-5513 Ph: (843) 722-4112 | 3973 Rivers Ave N Charleston SC 29405-7058 Ph: (843) 722-4112 |
NPI Number | 1245348457 |
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Provider Enumeration Date | 08/28/2006 |
Last Update Date | 10/28/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245348457 | NPI | - | NPPES |
FQC054 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Palmetto Primary Care Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2550 Elms Center Rd, N Charleston, SC 29406 Phone: 843-572-7727 Fax: 843-569-5872 |