| Forestview Primary Care | |
|
511 N Highway 52 Moncks Corner SC 29461-3132 | |
| (843) 761-0936 | |
| (843) 761-0938 |
| Full Name | Forestview Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 511 N Highway 52, Moncks Corner, South Carolina |
| Authorized Official Name and Position | Terry Duane Johnson (PRESIDENT / CEO) |
| Authorized Official Contact | 8645906561 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Forestview Primary Care Po Box 17190 Medical Staff Office Las Vegas NV 89114-7190 Ph: (702) 560-2916 | Forestview Primary Care 511 N Highway 52 Moncks Corner SC 29461-3132 Ph: (843) 761-0936 |
| NPI Number | 1467751495 |
|---|---|
| Provider Enumeration Date | 03/16/2011 |
| Last Update Date | 06/03/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467751495 | NPI | - | NPPES |
| GP5644 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 7353 (South Carolina) | Primary |
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