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300 Rice Meadow Way Columbia SC 29229-9466 | |
(803) 779-1420 | |
(803) 931-0676 |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 300 Rice Meadow Way, Columbia, South Carolina |
Authorized Official Name and Position | Stephen F Serbin (CEO/MEDICAL DIRECTOR) |
Authorized Official Contact | 8037791420 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1910 Gregg St Columbia SC 29201-2618 Ph: (803) 779-1420 | 300 Rice Meadow Way Columbia SC 29229-9466 Ph: (803) 779-1420 |
NPI Number | 1265525463 |
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Provider Enumeration Date | 10/02/2006 |
Last Update Date | 11/08/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265525463 | NPI | - | NPPES |
GP4014 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Northlake Family Medical Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3000 Ne Medical Park, Ste 101, Columbia, SC 29223 Phone: 803-419-5131 Fax: 803-419-5130 | |
Lagniappe Medical Clinics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 74 Polo Rd, Columbia, SC 29223 Phone: 803-419-7780 Fax: 803-419-7781 | |