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2801 Woodruff Rd Ste 101 Simpsonville SC 29681-4807 | |
(864) 849-9170 | |
(864) 849-9193 |
Full Name | |
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Speciality | Family Medicine |
Location | 2801 Woodruff Rd Ste 101, Simpsonville, South Carolina |
Authorized Official Name and Position | Kenneth Meinke (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 8645606000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 743070 Atlanta GA 30374-3070 Ph: (864) 560-4304 | 2801 Woodruff Rd Ste 101 Simpsonville SC 29681-4807 Ph: (864) 849-9170 |
NPI Number | 1558527416 |
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Provider Enumeration Date | 07/31/2008 |
Last Update Date | 07/18/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558527416 | NPI | - | NPPES |
CN1627 | Other | SC | RAILROAD MEDICARE |
GP5636 | Medicaid | SC | |
GP1118 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Fairview Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Fairview Pointe Dr., Simpsonville, SC 29681 Phone: 864-967-4982 Fax: 864-967-8465 | |
Cvs Caremark Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2580 Woodruff Rd, Simpsonville, SC 29681 Phone: 864-627-7229 | |
Soraya, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 25 Appian Cir, Simpsonville, SC 29681 Phone: 864-254-9487 Fax: 864-254-9487 |