| Mcleod Health Clarendon | |
|
512 Nelson Blvd Ste 200 Kingstree SC 29556-4027 | |
| (843) 355-5459 | |
| Not Available |
| Full Name | Mcleod Health Clarendon |
|---|---|
| Speciality | Family Medicine |
| Location | 512 Nelson Blvd Ste 200, Kingstree, 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 |
|---|---|
| Mcleod Health Clarendon Po Box 100567 Florence SC 29502-0567 Ph: () - | Mcleod Health Clarendon 512 Nelson Blvd Ste 200 Kingstree SC 29556-4027 Ph: (843) 355-5459 |
| NPI Number | 1326693953 |
|---|---|
| Provider Enumeration Date | 08/09/2019 |
| Last Update Date | 08/09/2019 |
| Medicare PECOS PAC ID | 0840582656 |
|---|---|
| Medicare Enrollment ID | O20191021002105 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326693953 | NPI | - | NPPES |
| 42-3857 | Other | SC | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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