| Dr Penelope Anne Campbell, MD | |
|
4022 Postal Way Ste C, Myrtle Beach, SC 29579-3537 | |
| (843) 903-4111 | |
| (843) 903-4242 |
| Full Name | Dr Penelope Anne Campbell |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 4022 Postal Way Ste C, Myrtle Beach, 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 |
|---|---|---|---|
| 1124084876 | NPI | - | NPPES |
| 7844 | Other | SC | MEDICARE PTAN |
| 570783896 | Other | SC | FED TAX ID |
| GP4505 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2080A0000X | Pediatrics - Adolescent Medicine | 27349 (South Carolina) | Secondary |
| 208000000X | Pediatrics | 27349 (South Carolina) | Primary |
| Entity Name | Careteam Plus Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427363209 PECOS PAC ID: 2961678289 Enrollment ID: O20120106000726 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Penelope Anne Campbell, MD Po Box 50760, Myrtle Beach, SC 29579-0013 Ph: (843) 903-4111 | Dr Penelope Anne Campbell, MD 4022 Postal Way Ste C, Myrtle Beach, SC 29579-3537 Ph: (843) 903-4111 |
Anna Marie Goodwin, DO Pediatrics Medicare: May Accept Medicare Assignments Practice Location: 4320 Holmestown Rd, Myrtle Beach, SC 29588 Phone: 843-652-8440 Fax: 843-652-8441 | |
Stephen Replenski, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 4022 Postal Way Ste C, Myrtle Beach, SC 29579 Phone: 843-903-4111 Fax: 843-903-4242 | |
Dr. Kristin Emily Moore, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 8120 Rourk St, Myrtle Beach, SC 29572 Phone: 843-449-1438 Fax: 843-286-1349 | |
Rebecca S Eglen, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 6010 Highway 707, Ste 300, Myrtle Beach, SC 29588 Phone: 843-293-1005 Fax: 843-293-1006 | |
Dr. Virginia Caroline Williams, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 8120 Rourk St, Myrtle Beach, SC 29572 Phone: 843-449-1483 Fax: 843-286-1349 | |
Dr. Frank Nicholas Colvard, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 8120 Rourk St, Myrtle Beach, SC 29572 Phone: 843-449-1438 Fax: 843-286-1349 |