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1076 Marlboro Way Ste 3 Bennettsville SC 29512-2495 | |
(843) 479-0432 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 1076 Marlboro Way Ste 3, Bennettsville, South Carolina |
Authorized Official Name and Position | Samuel Fulton Ervin (SR VICE PRESIDENT AND CFO) |
Authorized Official Contact | 8437772910 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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555 E Cheves St Florence SC 29506-2617 Ph: (843) 777-5562 | 1076 Marlboro Way Ste 3 Bennettsville SC 29512-2495 Ph: (843) 479-0432 |
NPI Number | 1538707146 |
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Provider Enumeration Date | 12/13/2019 |
Last Update Date | 09/28/2020 |
Medicare PECOS PAC ID | 7911228259 |
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Medicare Enrollment ID | O20200330003776 |
Identifier | Type | State | Issuer |
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1538707146 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Caresouth Carolina, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 999 Cheraw St, Bennettsville, SC 29512 Phone: 843-479-2341 | |