| Mrs Chermaine Latrice Lyde, DMD | |
|
8063 Edmund Hwy, Pelion, SC 29123-9805 | |
| (803) 894-3736 | |
| (803) 894-5315 |
| Full Name | Mrs Chermaine Latrice Lyde |
|---|---|
| Gender | Female |
| Speciality | Dentist |
| Location | 8063 Edmund Hwy, Pelion, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689830226 | NPI | - | NPPES |
| ZX4423 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4423 (South Carolina) | Primary |
| Entity Name | Eau Claire Cooperative Health Center, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346249430 PECOS PAC ID: 3274434220 Enrollment ID: O20040114000335 |
| Entity Name | Beaufort Jasper Hampton Comprehensive Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649276148 PECOS PAC ID: 5597675728 Enrollment ID: O20160427001262 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Chermaine Latrice Lyde, DMD Po Box 3788, Columbia, SC 29230-3788 Ph: (803) 733-5969 | Mrs Chermaine Latrice Lyde, DMD 8063 Edmund Hwy, Pelion, SC 29123-9805 Ph: (803) 894-3736 |
Dr. Wanda D Gibson, DDS Dentist Medicare: Medicare Enrolled Practice Location: 8063 Edmund Hwy, Eau Claire Cooperative Health Centers, Pelion, SC 29123 Phone: 803-894-3736 Fax: 803-894-5315 |