South Carolina Department Of Corrections | |
4444 Broad River Rd Columbia SC 29210-4012 | |
(803) 896-2707 | |
Not Available |
Full Name | South Carolina Department Of Corrections |
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Speciality | General Practice |
Location | 4444 Broad River Rd, Columbia, South Carolina |
Authorized Official Name and Position | John Branham Tomarchio (MEDICAL DIRECTOR) |
Authorized Official Contact | 8038961233 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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South Carolina Department Of Corrections 4444 Broad River Rd P. O. Box 21787 Columbia SC 29210-4012 Ph: (803) 896-2707 | South Carolina Department Of Corrections 4444 Broad River Rd Columbia SC 29210-4012 Ph: (803) 896-2707 |
NPI Number | 1104259340 |
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Provider Enumeration Date | 08/12/2013 |
Last Update Date | 08/12/2013 |
Identifier | Type | State | Issuer |
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1104259340 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | 33514 (South Carolina) | 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 | |