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755 E Smith St Timmonsville SC 29161-9430 | |
(843) 346-3900 | |
(843) 346-7839 |
Full Name | |
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Speciality | Family Medicine |
Location | 755 E Smith St, Timmonsville, South Carolina |
Authorized Official Name and Position | Paul Provenzano (REGIONAL PRACTICE MANAGER/AVP) |
Authorized Official Contact | 8437777030 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 3239 Florence SC 29502-3239 Ph: (843) 346-3900 | 755 E Smith St Timmonsville SC 29161-9430 Ph: (843) 346-3900 |
NPI Number | 1528162112 |
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Provider Enumeration Date | 09/12/2006 |
Last Update Date | 03/27/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528162112 | NPI | - | NPPES |
RHC170 | Medicaid | SC | |
GP1781 | Medicaid | SC | |
RHC137 | Medicaid | SC |