| Rb Stall High School | |
|
3625 Ashley Phosphate Rd North Charleston SC 29418-8559 | |
| (843) 764-2200 | |
| Not Available |
| Full Name | Rb Stall High School |
|---|---|
| Speciality | Clinic/Center |
| Location | 3625 Ashley Phosphate Rd, North Charleston, South Carolina |
| Authorized Official Name and Position | Aretha R Jones (CEO) |
| Authorized Official Contact | 8437224112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rb Stall High School 51 Nassau St Charleston SC 29403-5513 Ph: (843) 722-4112 | Rb Stall High School 3625 Ashley Phosphate Rd North Charleston SC 29418-8559 Ph: (843) 764-2200 |
| NPI Number | 1932845591 |
|---|---|
| Provider Enumeration Date | 05/06/2022 |
| Last Update Date | 05/09/2022 |
| Medicare PECOS PAC ID | 9032215199 |
|---|---|
| Medicare Enrollment ID | O20221012003721 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932845591 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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