| Moncks Corner Pediatrics Llc | |
|
5000 Epson Plantation Dr Ste B Moncks Corner SC 29461-3979 | |
| (843) 761-2000 | |
| (843) 761-2267 |
| Full Name | Moncks Corner Pediatrics Llc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 5000 Epson Plantation Dr Ste B, Moncks Corner, South Carolina |
| Authorized Official Name and Position | Joseph R West (OWNER) |
| Authorized Official Contact | 8437612000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moncks Corner Pediatrics Llc 5000 Epson Plantation Dr Ste B Moncks Corner SC 29461-3979 Ph: (843) 761-2000 | Moncks Corner Pediatrics Llc 5000 Epson Plantation Dr Ste B Moncks Corner SC 29461-3979 Ph: (843) 761-2000 |
| NPI Number | 1245550821 |
|---|---|
| Provider Enumeration Date | 06/07/2010 |
| Last Update Date | 06/07/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245550821 | NPI | - | NPPES |
| RHC188 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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