| Medical Building, Pa | |
|
1530 High Market St Georgetown SC 29440 | |
| (843) 546-5128 | |
| (843) 527-7500 |
| Full Name | Medical Building, Pa |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 1530 High Market St, Georgetown, South Carolina |
| Authorized Official Name and Position | Sue Stark (COADMINISTRATOR) |
| Authorized Official Contact | 8435274442 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Building, Pa 1075 N Fraser St Georgetown SC 29440-2848 Ph: (843) 527-4442 | Medical Building, Pa 1530 High Market St Georgetown SC 29440 Ph: (843) 546-5128 |
| NPI Number | 1598818098 |
|---|---|
| Provider Enumeration Date | 01/19/2007 |
| Last Update Date | 04/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598818098 | NPI | - | NPPES |
| RHC167 | Medicaid | SC | |
| RHC051 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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