| Eastover Family Practice | |
|
3041 Old Eastover Road Eastover SC 29044-2417 | |
| (803) 353-8741 | |
| (803) 353-8789 |
| Full Name | Eastover Family Practice |
|---|---|
| Speciality | Clinic/Center |
| Location | 3041 Old Eastover Road, Eastover, South Carolina |
| Authorized Official Name and Position | Delgado Cantave (CEO) |
| Authorized Official Contact | 8037335969 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastover Family Practice Po Box 3788 Columbia SC 29230-3788 Ph: (803) 733-5969 | Eastover Family Practice 3041 Old Eastover Road Eastover SC 29044-2417 Ph: (803) 353-8741 |
| NPI Number | 1811294978 |
|---|---|
| Provider Enumeration Date | 02/24/2011 |
| Last Update Date | 02/10/2022 |
| Medicare PECOS PAC ID | 3274434220 |
|---|---|
| Medicare Enrollment ID | O20120622000332 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811294978 | NPI | - | NPPES |
| CBP018 | Medicaid | SC | |
| FQC031 | Medicaid | SC | |
| FQC132 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (South Carolina) | Primary |
Colonial Family Practice, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10441 Garners Ferry Rd, Eastover, SC 29044 Phone: 803-773-5227 |