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229 Longtown Rd Columbia SC 29229-8550 | |
(803) 419-4949 | |
(803) 419-6445 |
Full Name | |
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Speciality | Family Medicine |
Location | 229 Longtown Rd, Columbia, South Carolina |
Authorized Official Name and Position | Melinda Sarvis (EXECUTIVE VICE PRESIDENT) |
Authorized Official Contact | 8037912000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 896239 Charlotte NC 28289-6239 Ph: (803) 419-4949 | 229 Longtown Rd Columbia SC 29229-8550 Ph: (803) 419-4949 |
NPI Number | 1053643841 |
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Provider Enumeration Date | 02/04/2010 |
Last Update Date | 09/18/2018 |
Identifier | Type | State | Issuer |
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1053643841 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (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 | |