| The Pendergrass Family Health Center | |
|
85 S Greenwood Ave Ware Shoals SC 29692-1534 | |
| (864) 456-7436 | |
| (864) 456-2942 |
| Full Name | The Pendergrass Family Health Center |
|---|---|
| Speciality | Family Medicine |
| Location | 85 S Greenwood Ave, Ware Shoals, South Carolina |
| Authorized Official Name and Position | Lisa Y Gilmer (REVENUE CYCLE MANAGER) |
| Authorized Official Contact | 8649418121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Pendergrass Family Health Center 93 S Greenwood Ave Po Box 389 Ware Shoals SC 29692-1534 Ph: (864) 456-7436 | The Pendergrass Family Health Center 85 S Greenwood Ave Ware Shoals SC 29692-1534 Ph: (864) 456-7436 |
| NPI Number | 1639202922 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 10/24/2018 |
| Medicare PECOS PAC ID | 5496707804 |
|---|---|
| Medicare Enrollment ID | O20100614000491 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639202922 | NPI | - | NPPES |
| FQC019 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
Family Healthcare Ware Shoals A Division Of Self Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 167 Greenwood Ave S, Ware Shoals, SC 29692 Phone: 864-456-3447 Fax: 864-725-4979 |