Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 701 S Morgan Ave, Andrews, South Carolina |
Authorized Official Name and Position | Elizabeth Sutherland Ward (EVP & CFO) |
Authorized Official Contact | 8435277102 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 421718 Georgetown SC 29442-4203 Ph: (843) 520-8330 | 701 S Morgan Ave Andrews SC 29510 Ph: (843) 264-5253 |
NPI Number | 1104995372 |
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Provider Enumeration Date | 11/06/2006 |
Last Update Date | 05/01/2020 |
Medicare PECOS PAC ID | 2365697398 |
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Medicare Enrollment ID | O20141021001385 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104995372 | NPI | - | NPPES |
RHC068 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |