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8548 Willtown Rd Hollywood SC 29449-5515 | |
(843) 723-9582 | |
(843) 723-7011 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 8548 Willtown Rd, Hollywood, South Carolina |
Authorized Official Name and Position | Aretha Jones (CEO) |
Authorized Official Contact | 8437224112 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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51 Nassau St Charleston SC 29403-5513 Ph: (843) 722-4112 | 8548 Willtown Rd Hollywood SC 29449-5515 Ph: (843) 723-9582 |
NPI Number | 1477004133 |
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Provider Enumeration Date | 10/18/2016 |
Last Update Date | 10/18/2016 |
Identifier | Type | State | Issuer |
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1477004133 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Renovo Medical Consulting Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4770 Stono Links Dr, Hollywood, SC 29449 Phone: 615-714-6035 | |