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8301 Farrow Rd Columbia SC 29203-3245 | |
(803) 898-8405 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 8301 Farrow Rd, Columbia, South Carolina |
Authorized Official Name and Position | Versie Bellamy (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 8039355761 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 485 Columbia SC 29202-0485 Ph: (803) 898-8405 | 8301 Farrow Rd Columbia SC 29203-3245 Ph: (803) 898-8405 |
NPI Number | 1184675316 |
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Provider Enumeration Date | 05/12/2006 |
Last Update Date | 09/20/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184675316 | NPI | - | NPPES |
420039 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (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 | |