| St Andrews Medical Inc | |
|
1249a Savannah Hwy Charleston SC 29407-7826 | |
| (843) 763-2000 | |
| (843) 763-2325 |
| Full Name | St Andrews Medical Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1249a Savannah Hwy, Charleston, South Carolina |
| Authorized Official Name and Position | Ruth Dehaven (OWNER) |
| Authorized Official Contact | 8437632000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Andrews Medical Inc 1249a Savannah Hwy Charleston SC 29407-7826 Ph: (843) 763-2000 | St Andrews Medical Inc 1249a Savannah Hwy Charleston SC 29407-7826 Ph: (843) 763-2000 |
| NPI Number | 1144358425 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 01/31/2008 |
| Medicare PECOS PAC ID | 0648338152 |
|---|---|
| Medicare Enrollment ID | O20081027000668 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144358425 | NPI | - | NPPES |
| TL6836 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 16710 (South Carolina) | Primary |
| Provider Name | Ruth S Dehaven |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1841265220 PECOS PAC ID: 0749348258 Enrollment ID: I20081027000655 |
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