Full Name | |
---|---|
Speciality | Family Medicine |
Location | 722 Hyatt St, Gaffney, South Carolina |
Authorized Official Name and Position | Debbie Brewer (DIRECTOR OF PROVIDER ENROLLMENT) |
Authorized Official Contact | 6154657000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 406757 Atlanta GA 30384-6757 Ph: (864) 253-8080 | 722 Hyatt St Gaffney SC 29341-2643 Ph: (864) 488-1400 |
NPI Number | 1548282486 |
---|---|
Provider Enumeration Date | 07/23/2006 |
Last Update Date | 06/25/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548282486 | NPI | - | NPPES |
GP2805 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Cherokee Community Care, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1307 N Logan St, Gaffney, SC 29341 Phone: 864-488-1333 | |