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14 Richland Medical Park Drive Suite 310 Columbia SC 29203 | |
(803) 434-2300 | |
(803) 434-8686 |
Full Name | |
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Speciality | Clinic/center |
Location | 14 Richland Medical Park Drive Suite 310, Columbia, South Carolina |
Authorized Official Name and Position | Thomas B Eckert (DIR OF PHS) |
Authorized Official Contact | 8032962548 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5 Richland Medical Park Columbia SC 29203 Ph: (803) 296-2548 | 14 Richland Medical Park Drive Suite 310 Columbia SC 29203 Ph: (803) 434-2300 |
NPI Number | 1487846986 |
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Provider Enumeration Date | 08/17/2007 |
Last Update Date | 04/27/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487846986 | NPI | - | NPPES |
GP1795 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (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 | |