| |
511 S Main St Mullins SC 29574-3509 | |
(843) 464-8244 | |
(843) 464-6519 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 511 S Main St, Mullins, South Carolina |
Authorized Official Name and Position | Harold E Tucker (CEO) |
Authorized Official Contact | 8434312405 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 388 Mullins SC 29574-0388 Ph: (843) 464-8244 | 511 S Main St Mullins SC 29574-3509 Ph: (843) 464-8244 |
NPI Number | 1972553691 |
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Provider Enumeration Date | 05/11/2006 |
Last Update Date | 08/18/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972553691 | NPI | - | NPPES |
428956 | Other | SC | MEDICARE RHC |
428956 | Other | SC | OSCAR |
PA3013 | Medicaid | SC | |
8178 | Other | SC | MEDICARE ID TYPE UNSPECIFIED |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (South Carolina) | Primary |
Medical University Hospital Authority Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 511 S Main St, Mullins, SC 29574 Phone: 843-464-8244 | |
Palmetto Medical Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1002 S Main St, Mullins, SC 29574 Phone: 843-245-0613 | |