| Community Wellness Group Llc | |
|
2430 Atlas Rd Ste 1 Columbia SC 29209-3625 | |
| (803) 586-1752 | |
| (877) 995-5934 |
| Full Name | Community Wellness Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2430 Atlas Rd Ste 1, Columbia, South Carolina |
| Authorized Official Name and Position | Kenneth Allan Simmons (DIRECTOR/MANAGER) |
| Authorized Official Contact | 8035861752 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Wellness Group Llc 7356 Garners Ferry Rd Suite 130 Columbia SC 29209-2178 Ph: (803) 586-1752 | Community Wellness Group Llc 2430 Atlas Rd Ste 1 Columbia SC 29209-3625 Ph: (803) 586-1752 |
| NPI Number | 1982144606 |
|---|---|
| Provider Enumeration Date | 02/28/2017 |
| Last Update Date | 12/07/2021 |
| Certification Date | 12/07/2021 |
| Medicare PECOS PAC ID | 9234481060 |
|---|---|
| Medicare Enrollment ID | O20181005002437 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982144606 | NPI | - | NPPES |
| GP8968 | Medicaid | SC |
| Provider Name | Green B Neal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619938685 PECOS PAC ID: 6608824313 Enrollment ID: I20050110000689 |
| Provider Name | Francis Dowdy Gill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427515006 PECOS PAC ID: 2163764127 Enrollment ID: I20190424000477 |
| Provider Name | Hope Ballard Hopkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124656699 PECOS PAC ID: 9739500885 Enrollment ID: I20200528002003 |
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