Palmetto Primary Care | |
330 Mercy St Lake City SC 29560-2332 | |
(843) 374-9355 | |
(843) 374-9358 |
Full Name | Palmetto Primary Care |
---|---|
Speciality | Family Medicine |
Location | 330 Mercy St, Lake City, South Carolina |
Authorized Official Name and Position | Mary C Duke (DIRECTOR OF PFS) |
Authorized Official Contact | 8433746431 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Palmetto Primary Care 258 N Ron Mcnair Blvd Lake City SC 29560-2462 Ph: (843) 374-2036 | Palmetto Primary Care 330 Mercy St Lake City SC 29560-2332 Ph: (843) 374-9355 |
NPI Number | 1063613099 |
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Provider Enumeration Date | 05/29/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063613099 | NPI | - | NPPES |
GP3704 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | GP3704 (South Carolina) | Primary |
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