Ridge Spring Family Practice | |
201 Aiken Rd. Ridge Spring SC 29129 | |
(803) 685-3100 | |
(803) 685-5831 |
Full Name | Ridge Spring Family Practice |
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Speciality | Clinic/Center |
Location | 201 Aiken Rd., Ridge Spring, South Carolina |
Authorized Official Name and Position | Lisa Y Gilmer (PRACTICE ADMINISTRATOR) |
Authorized Official Contact | 8649418121 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ridge Spring Family Practice Po Box 128 Ridge Spring SC 29129 Ph: (803) 685-3100 | Ridge Spring Family Practice 201 Aiken Rd. Ridge Spring SC 29129 Ph: (803) 685-3100 |
NPI Number | 1538127352 |
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Provider Enumeration Date | 05/02/2006 |
Last Update Date | 06/21/2010 |
Medicare PECOS PAC ID | 5496707804 |
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Medicare Enrollment ID | O20100615000536 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538127352 | NPI | - | NPPES |
FQC020 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |