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1040 Marlboro Way Suite 1 Bennettsville SC 29512-2494 | |
(843) 479-5890 | |
(843) 479-3524 |
Full Name | |
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Speciality | Family Medicine |
Location | 1040 Marlboro Way, Bennettsville, South Carolina |
Authorized Official Name and Position | Dane P. Ficco (SENIOR VICE PRESIDENT) |
Authorized Official Contact | 8437777010 |
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) 777-7162 | 1040 Marlboro Way Suite 1 Bennettsville SC 29512-2494 Ph: (843) 479-5890 |
NPI Number | 1497134852 |
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Provider Enumeration Date | 05/19/2015 |
Last Update Date | 05/19/2015 |
Identifier | Type | State | Issuer |
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1497134852 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (South Carolina) | Primary |
363LF0000X | Nurse Practitioner - Family | (South Carolina) | Secondary |
Caresouth Carolina, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 999 Cheraw St, Bennettsville, SC 29512 Phone: 843-479-2341 | |