<unavail> in Hollywood, SC - Medicare Clinic/Center

is a medicare enrolled primary clinic (Clinic/center) in Hollywood, South Carolina. The current practice location for is 7610 Highway 164, Hollywood, South Carolina. For appointments, you can reach them via phone at (843) 889-8018. The mailing address for is Po Box 1355, Hollywood, South Carolina and phone number is (843) 889-8018.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1740402130. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (843) 889-8018.

Contact Information


	7610 Highway 164 Hollywood SC 29449
	(843) 889-8018
	(843) 889-9133

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Clinic/Center
Location	7610 Highway 164, Hollywood, South Carolina
Authorized Official Name and Position	Marsha Gay Delavan (PRESIDENT)
Authorized Official Contact	8438898018
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Po Box 1355 Hollywood SC 29449-1355 Ph: (843) 889-8018	7610 Highway 164 Hollywood SC 29449 Ph: (843) 889-8018

NPI Details:

NPI Number	1740402130
Provider Enumeration Date	05/03/2007
Last Update Date	12/28/2009

Medicare PECOS Information:

Medicare PECOS PAC ID	9436187986
Medicare Enrollment ID	O20050727000442

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1740402130	NPI	-	NPPES
42D0968299	Other	SC	CLIA NUMBER
GP2603	Medicaid	SC

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261Q00000X	Clinic/center	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:

Provider Name	Anne Knight
Provider Type	Practitioner - Family Practice
Provider Identifiers	NPI Number: 1992816821 PECOS PAC ID: 0749294130 Enrollment ID: I20060206000885

Reviews and Comments

Clinic/Center in Hollywood, SC

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- Medicare Primary Care in Hollywood, SC