| Fields Health Clinic, Llc | |
|
3930 Devine St Columbia SC 29205-2804 | |
| (803) 787-7050 | |
| (803) 787-0502 |
| Full Name | Fields Health Clinic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3930 Devine St, Columbia, South Carolina |
| Authorized Official Name and Position | James M Fields (OWNER) |
| Authorized Official Contact | 8033617262 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fields Health Clinic, Llc 3930 Devine St Columbia SC 29205-2804 Ph: (803) 787-7050 | Fields Health Clinic, Llc 3930 Devine St Columbia SC 29205-2804 Ph: (803) 787-7050 |
| NPI Number | 1366890295 |
|---|---|
| Provider Enumeration Date | 06/01/2016 |
| Last Update Date | 06/01/2016 |
| Medicare PECOS PAC ID | 7315221025 |
|---|---|
| Medicare Enrollment ID | O20170224000646 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366890295 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 17854 (South Carolina) | Primary |
| 261QP2300X | Clinic/center - Primary Care | 17853 (South Carolina) | Secondary |
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