Springwood Lake Primary Care, Llc | |
1721 Horseshoe Dr Columbia SC 29223-6281 | |
(803) 626-0600 | |
(803) 626-0700 |
Full Name | Springwood Lake Primary Care, Llc |
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Speciality | Clinic/Center |
Location | 1721 Horseshoe Dr, Columbia, South Carolina |
Authorized Official Name and Position | Stephen F Serbin (PRESIDENT) |
Authorized Official Contact | 8036260600 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Springwood Lake Primary Care, Llc 1721 Horseshoe Dr Columbia SC 29223-6281 Ph: (803) 626-0600 | Springwood Lake Primary Care, Llc 1721 Horseshoe Dr Columbia SC 29223-6281 Ph: (803) 626-0600 |
NPI Number | 1841797081 |
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Provider Enumeration Date | 04/12/2018 |
Last Update Date | 09/10/2020 |
Medicare PECOS PAC ID | 8022363977 |
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Medicare Enrollment ID | O20180615002551 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841797081 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Jennifer G Rice |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063690907 PECOS PAC ID: 1658445432 Enrollment ID: I20080926000493 |
Provider Name | Stephen F Serbin |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1992715684 PECOS PAC ID: 3375500671 Enrollment ID: I20110425000647 |
Provider Name | Linda Louise Hundley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750364519 PECOS PAC ID: 9537381850 Enrollment ID: I20180720001533 |
Provider Name | Jerri N Masanovich |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366922866 PECOS PAC ID: 6709138175 Enrollment ID: I20181012000730 |
Provider Name | Susan Elizabeth Petrin |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831502103 PECOS PAC ID: 3476848334 Enrollment ID: I20181219003197 |
Provider Name | Caroline Davis White |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326479361 PECOS PAC ID: 9234404435 Enrollment ID: I20210203000825 |
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 | |