| Wagner Medical Center, Williston Medical Center, Blackville Medical Ce | |
|
22 Gardner Rd Blackville SC 29817-3126 | |
| (803) 641-6277 | |
| Not Available |
| Full Name | Wagner Medical Center, Williston Medical Center, Blackville Medical Ce |
|---|---|
| Speciality | Family Medicine |
| Location | 22 Gardner Rd, Blackville, South Carolina |
| Authorized Official Name and Position | Charlie Clifton Alsbrooks (ADMINISTRATOR) |
| Authorized Official Contact | 8036416277 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wagner Medical Center, Williston Medical Center, Blackville Medical Ce 22 Gardner Rd P. O. Box 247 Blackville SC 29817-3126 Ph: (803) 641-6277 | Wagner Medical Center, Williston Medical Center, Blackville Medical Ce 22 Gardner Rd Blackville SC 29817-3126 Ph: (803) 641-6277 |
| NPI Number | 1871757385 |
|---|---|
| Provider Enumeration Date | 07/14/2008 |
| Last Update Date | 07/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871757385 | NPI | - | NPPES |
| GP0847 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Blackville Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 22 Gardner Rd, Blackville, SC 29817 Phone: 803-284-2041 Fax: 803-284-5516 | |
Family Medical Center Of Blackville Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 130 Baker Street, Blackville, SC 29817 Phone: 803-284-1045 Fax: 803-284-3094 | |
Blackville Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 22 Gardner Rd, Blackville, SC 29817 Phone: 803-284-2041 Fax: 803-284-5516 | |
Blackville Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 22 Gardner Rd, Blackville, SC 29817 Phone: 803-284-2041 Fax: 803-284-5516 | |
Blackville Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 22 Gardener Rd, Box 247, Blackville, SC 29817 Phone: 803-284-2041 Fax: 803-284-5516 |