| Ph Pediatrics-powdersville | |
|
207 Three Bridges Rd Greenville SC 29611-7549 | |
| (864) 220-1110 | |
| (864) 220-1104 |
| Full Name | Ph Pediatrics-powdersville |
|---|---|
| Speciality | Clinic/Center |
| Location | 207 Three Bridges Rd, Greenville, South Carolina |
| Authorized Official Name and Position | Polly H. Miller (SVP FINANCE, ENTERPRISE CONTRACTING) |
| Authorized Official Contact | 8645222286 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ph Pediatrics-powdersville 300 E Mcbee Ave Fl 4 Greenville SC 29601-2842 Ph: (864) 522-8603 | Ph Pediatrics-powdersville 207 Three Bridges Rd Greenville SC 29611-7549 Ph: (864) 220-1110 |
| NPI Number | 1730770744 |
|---|---|
| Provider Enumeration Date | 02/02/2021 |
| Last Update Date | 02/24/2022 |
| Medicare PECOS PAC ID | 5698063162 |
|---|---|
| Medicare Enrollment ID | O20210316000977 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730770744 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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