Magnolia Clinic | |
504 Segars Mill Rd Hartsville SC 29550-8070 | |
(843) 621-0799 | |
Not Available |
Full Name | Magnolia Clinic |
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Speciality | Clinic/Center |
Location | 504 Segars Mill Rd, Hartsville, South Carolina |
Authorized Official Name and Position | Emmanuel O Quaye (PROPRIETOR) |
Authorized Official Contact | 8436210799 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Magnolia Clinic Po Box 1469 Hartsville SC 29551-1469 Ph: (843) 621-0799 | Magnolia Clinic 504 Segars Mill Rd Hartsville SC 29550-8070 Ph: (843) 621-0799 |
NPI Number | 1255563870 |
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Provider Enumeration Date | 08/15/2009 |
Last Update Date | 08/15/2009 |
Medicare PECOS PAC ID | 1658415930 |
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Medicare Enrollment ID | O20100224000826 |
Identifier | Type | State | Issuer |
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1255563870 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Nailah Roland |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1558656421 PECOS PAC ID: 4385963529 Enrollment ID: I20150508002368 |
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