| Medical Group Of The Carolinas - Family Medicine - Five Forks | |
|
2801 Woodruff Rd Ste 101 Simpsonville SC 29681-4807 | |
| (864) 849-9170 | |
| (864) 849-9193 |
| Full Name | Medical Group Of The Carolinas - Family Medicine - Five Forks |
|---|---|
| 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 |
|---|---|
| Medical Group Of The Carolinas - Family Medicine - Five Forks Po Box 743070 Atlanta GA 30374-3070 Ph: (864) 560-4304 | Medical Group Of The Carolinas - Family Medicine - Five Forks 2801 Woodruff Rd Ste 101 Simpsonville SC 29681-4807 Ph: (864) 849-9170 |
| NPI Number | 1558527416 |
|---|---|
| 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 |
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