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308 Chester Ave Great Falls SC 29055-1104 | |
(843) 792-1414 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 308 Chester Ave, Great Falls, South Carolina |
Authorized Official Name and Position | Karyn Rae (CHIEF PAYOR RELATIONS AND REIMBURSE) |
Authorized Official Contact | 8438761344 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 23467 New York NY 10087-3467 Ph: (843) 792-6200 | 308 Chester Ave Great Falls SC 29055-1104 Ph: (843) 792-1414 |
NPI Number | 1417684192 |
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Provider Enumeration Date | 08/03/2022 |
Last Update Date | 12/02/2024 |
Medicare PECOS PAC ID | 1557268950 |
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Medicare Enrollment ID | O20220919001742 |
Identifier | Type | State | Issuer |
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1417684192 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Great Falls Consulting Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 503 Chester Ave Ste A, Great Falls, SC 29055 Phone: 803-482-7545 |