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2835 E Highway 76 Suite 7 Mullins SC 29574-6038 | |
(843) 431-2710 | |
(843) 431-2716 |
Full Name | |
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Speciality | Family Medicine |
Location | 2835 E Highway 76, Mullins, South Carolina |
Authorized Official Name and Position | Harold E Tucker (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 8434312405 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1150 Marion SC 29571-1150 Ph: (843) 431-2710 | 2835 E Highway 76 Suite 7 Mullins SC 29574-6038 Ph: (843) 431-2710 |
NPI Number | 1336155761 |
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Provider Enumeration Date | 07/31/2006 |
Last Update Date | 06/24/2009 |
Identifier | Type | State | Issuer |
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1336155761 | NPI | - | NPPES |
GP4561 | Medicaid | SC | |
P00383970 | Other | SC | MEDICARE RAILROAD |
247904 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Medical University Hospital Authority Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 511 S Main St, Mullins, SC 29574 Phone: 843-464-8244 | |
Palmetto Medical Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1002 S Main St, Mullins, SC 29574 Phone: 843-245-0613 | |