| Powdersville Medical Park | |
|
15 Roe Rd Greenville SC 29611-7423 | |
| (864) 295-2308 | |
| (864) 295-2635 |
| Full Name | Powdersville Medical Park |
|---|---|
| Speciality | Family Medicine |
| Location | 15 Roe Rd, Greenville, South Carolina |
| Authorized Official Name and Position | Kendall Durham (PATIENT FINANCIAL MANAGER) |
| Authorized Official Contact | 8648555104 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Powdersville Medical Park Po Box 2089 Easley SC 29641-2089 Ph: (864) 855-5104 | Powdersville Medical Park 15 Roe Rd Greenville SC 29611-7423 Ph: (864) 295-2308 |
| NPI Number | 1568412476 |
|---|---|
| Provider Enumeration Date | 05/11/2006 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568412476 | NPI | - | NPPES |
| GP2174 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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