| Aids Healthcare Foundation | |
|
4100 N Main St Ste 102 Columbia SC 29203-5800 | |
| (803) 223-9895 | |
| (803) 735-3641 |
| Full Name | Aids Healthcare Foundation |
|---|---|
| Speciality | Internal Medicine |
| Location | 4100 N Main St Ste 102, Columbia, South Carolina |
| Authorized Official Name and Position | Lyle Honig Mojica (CFO) |
| Authorized Official Contact | 3238605305 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aids Healthcare Foundation 6255 W Sunset Blvd Fl 21 Los Angeles CA 90028-7422 Ph: (323) 860-5200 | Aids Healthcare Foundation 4100 N Main St Ste 102 Columbia SC 29203-5800 Ph: (803) 223-9895 |
| NPI Number | 1265784912 |
|---|---|
| Provider Enumeration Date | 10/04/2012 |
| Last Update Date | 03/06/2024 |
| Medicare PECOS PAC ID | 2668369109 |
|---|---|
| Medicare Enrollment ID | O20180605000845 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265784912 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Michelle A Rojas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205806718 PECOS PAC ID: 9234038787 Enrollment ID: I20040107000376 |
| Provider Name | Tonda P Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184690174 PECOS PAC ID: 0244207769 Enrollment ID: I20040914000930 |
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