| Palmetto Assisted Living Medical Group Pc | |
|
25 China Cockle Way Hilton Head SC 29926-1907 | |
| (717) 994-1711 | |
| Not Available |
| Full Name | Palmetto Assisted Living Medical Group Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 25 China Cockle Way, Hilton Head, South Carolina |
| Authorized Official Name and Position | David Castor (PRESIDENT) |
| Authorized Official Contact | 7179941711 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Palmetto Assisted Living Medical Group Pc Po Box 2029 Bryson City NC 28713-5029 Ph: (828) 735-2822 | Palmetto Assisted Living Medical Group Pc 25 China Cockle Way Hilton Head SC 29926-1907 Ph: (717) 994-1711 |
| NPI Number | 1083346258 |
|---|---|
| Provider Enumeration Date | 06/27/2022 |
| Last Update Date | 11/30/2023 |
| Medicare PECOS PAC ID | 2961878657 |
|---|---|
| Medicare Enrollment ID | O20221020003055 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083346258 | NPI | - | NPPES |
| 5917260 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | David Randall Castor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073735155 PECOS PAC ID: 1759559461 Enrollment ID: I20190429000807 |
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