| Eventus Wh Southeast - South Carolina, Llc | |
|
2 Office Park Ct Ste 103 Columbia SC 29223-5948 | |
| (855) 743-2247 | |
| Not Available |
| Full Name | Eventus Wh Southeast - South Carolina, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 2 Office Park Ct Ste 103, Columbia, South Carolina |
| Authorized Official Name and Position | George Hall (OWNER) |
| Authorized Official Contact | 8557432247 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eventus Wh Southeast - South Carolina, Llc Po Box 1431 Dept 417 Charlotte NC 28201-1431 Ph: (855) 742-2247 | Eventus Wh Southeast - South Carolina, Llc 2 Office Park Ct Ste 103 Columbia SC 29223-5948 Ph: (855) 743-2247 |
| NPI Number | 1790503571 |
|---|---|
| Provider Enumeration Date | 09/30/2024 |
| Last Update Date | 09/30/2024 |
| Medicare PECOS PAC ID | 5698201523 |
|---|---|
| Medicare Enrollment ID | O20241216000848 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790503571 | NPI | - | NPPES |
| Provider Name | Hosea Kibet Koech |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760173991 PECOS PAC ID: 6608236203 Enrollment ID: I20230713004125 |
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