| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 15 Roe Road, Greenville, South Carolina |
| Authorized Official Name and Position | Kendall J Durham (FINANCIAL SERVICE REP-MANAGER) |
| Authorized Official Contact | 8648555104 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 2089 Easley SC 29641-2089 Ph: (864) 855-5104 | 15 Roe Road Greenville SC 29611 Ph: (864) 295-2308 |
| NPI Number | 1518170182 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518170182 | NPI | - | NPPES |
| DE1915 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Cooke's Continence Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 330-c Pelham Road, Suite B-102, Greenville, SC 29615 Phone: 864-412-8424 Fax: 864-412-8012 | |
Midtown Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7 Pointe Cir, Greenville, SC 29615 Phone: 864-525-5400 | |
Greenville Functional Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 Halton Rd, Suite A, Greenville, SC 29607 Phone: 864-558-0200 Fax: 864-520-1245 | |
H And M Labs And Clinics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 137 Commons Way, Greenville, SC 29611 Phone: 864-979-0846 | |