| St. Lawrence Place | |
|
2400 Waites Rd Columbia SC 29204-1325 | |
| (803) 708-4861 | |
| (803) 753-5591 |
| Full Name | St. Lawrence Place |
|---|---|
| Speciality | Family Medicine |
| Location | 2400 Waites Rd, Columbia, South Carolina |
| Authorized Official Name and Position | Stuart A. Hamilton (CEO) |
| Authorized Official Contact | 8037335969 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Lawrence Place Po Box 3788 Columbia SC 29230-3788 Ph: (803) 733-5969 | St. Lawrence Place 2400 Waites Rd Columbia SC 29204-1325 Ph: (803) 708-4861 |
| NPI Number | 1760871115 |
|---|---|
| Provider Enumeration Date | 01/22/2015 |
| Last Update Date | 02/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760871115 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
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