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3250 Harden Street Ext Suite 200 Columbia SC 29203-6800 | |
(803) 434-1352 | |
(803) 434-1355 |
Full Name | |
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Speciality | Clinic/center |
Location | 3250 Harden Street Ext, Columbia, South Carolina |
Authorized Official Name and Position | Frank Chesno (DIRECTOR) |
Authorized Official Contact | 8032965001 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3250 Harden Street Ext Suite 200 Columbia SC 29203-6800 Ph: (803) 434-1352 | 3250 Harden Street Ext Suite 200 Columbia SC 29203-6800 Ph: (803) 434-1352 |
NPI Number | 1366488314 |
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Provider Enumeration Date | 06/20/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1366488314 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 0TP-050 (South Carolina) | Primary |
Northlake Family Medical Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3000 Ne Medical Park, Ste 101, Columbia, SC 29223 Phone: 803-419-5131 Fax: 803-419-5130 | |
Lagniappe Medical Clinics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 74 Polo Rd, Columbia, SC 29223 Phone: 803-419-7780 Fax: 803-419-7781 | |