| Sandhills Medical Foundation, Inc. | |
|
409 E Church St Jefferson SC 29718-8701 | |
| (843) 658-3005 | |
| (843) 658-7780 |
| Full Name | Sandhills Medical Foundation, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 409 E Church St, Jefferson, South Carolina |
| Authorized Official Name and Position | Ernest James Stanley Wardlaw (CEO) |
| Authorized Official Contact | 8433358291 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandhills Medical Foundation, Inc. Po Box 366 Mc Bee SC 29101-0366 Ph: (843) 658-3005 | Sandhills Medical Foundation, Inc. 409 E Church St Jefferson SC 29718-8701 Ph: (843) 658-3005 |
| NPI Number | 1912065467 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 09/29/2023 |
| Medicare PECOS PAC ID | 8224949821 |
|---|---|
| Medicare Enrollment ID | O20100831000298 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912065467 | NPI | - | NPPES |
| FQC022 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (South Carolina) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (South Carolina) | Primary |