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200 N Nelson Dr Fountain Inn SC 29644-9021 | |
(864) 522-6270 | |
(864) 522-6275 |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 200 N Nelson Dr, Fountain Inn, South Carolina |
Authorized Official Name and Position | Polly H Miller (SVP FINANCE, ENTERPRISE CONTRACTING) |
Authorized Official Contact | 8645222286 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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300 E Mcbee Ave Fl 4 Greenville SC 29601-2842 Ph: () - | 200 N Nelson Dr Fountain Inn SC 29644-9021 Ph: (864) 522-6270 |
NPI Number | 1164102927 |
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Provider Enumeration Date | 07/18/2023 |
Last Update Date | 10/12/2023 |
Identifier | Type | State | Issuer |
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1164102927 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |