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355 Cambridge Ave W Greenwood SC 29646-2191 | |
(864) 396-5268 | |
(864) 396-5269 |
Full Name | |
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Speciality | Clinic/Center |
Location | 355 Cambridge Ave W, Greenwood, South Carolina |
Authorized Official Name and Position | Lisa Y Gilmer (PRACTICE ADMINISTRATOR) |
Authorized Official Contact | 8649418121 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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313 Main St Ste B Greenwood SC 29646-2757 Ph: (864) 388-0301 | 355 Cambridge Ave W Greenwood SC 29646-2191 Ph: (864) 396-5268 |
NPI Number | 1538428198 |
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Provider Enumeration Date | 05/16/2012 |
Last Update Date | 05/25/2022 |
Medicare PECOS PAC ID | 5496707804 |
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Medicare Enrollment ID | O20120716000224 |
Identifier | Type | State | Issuer |
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1538428198 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
Carolina Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 313 Main St, Greenwood, SC 29646 Phone: 864-396-0117 Fax: 864-388-0648 | |
Hands Of Hope Children's Therapy Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 Maxwell Ave, Greenwood, SC 29646 Phone: 864-993-3302 |