Dba Brent Baroody Md | |
1523 Heritage Ln Florence SC 29505-3197 | |
(843) 673-9992 | |
(843) 673-9996 |
Full Name | Dba Brent Baroody Md |
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Speciality | Clinic/Center |
Location | 1523 Heritage Ln, Florence, South Carolina |
Authorized Official Name and Position | Tony Megna (CEO) |
Authorized Official Contact | 8032543676 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dba Brent Baroody Md 8906 Two Notch Rd Columbia SC 29223-6366 Ph: (803) 254-3676 | Dba Brent Baroody Md 1523 Heritage Ln Florence SC 29505-3197 Ph: (843) 673-9992 |
NPI Number | 1255305280 |
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Provider Enumeration Date | 02/15/2006 |
Last Update Date | 11/07/2023 |
Medicare PECOS PAC ID | 4688869696 |
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Medicare Enrollment ID | O20151211001300 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255305280 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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