| Metrolyna Health Care Llc | |
|
209 South College Street Heath Springs SC 29058 | |
| (803) 273-4018 | |
| (803) 273-4023 |
| Full Name | Metrolyna Health Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 209 South College Street, Heath Springs, South Carolina |
| Authorized Official Name and Position | Ifediora Foster Afulukwe (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8032734018 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Metrolyna Health Care Llc Po Box 49089 Charlotte NC 28277-0073 Ph: (803) 273-4018 | Metrolyna Health Care Llc 209 South College Street Heath Springs SC 29058 Ph: (803) 273-4018 |
| NPI Number | 1780761684 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 09/01/2016 |
| Medicare PECOS PAC ID | 6709935299 |
|---|---|
| Medicare Enrollment ID | O20090512000228 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780761684 | NPI | - | NPPES |
| GP2762 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | MD20627 (South Carolina) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | 20627 (South Carolina) | Primary |
| Provider Name | Ifedoria Foster Afulukwe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417912932 PECOS PAC ID: 4880743376 Enrollment ID: I20150224000832 |
| Provider Name | Clarence Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811448194 PECOS PAC ID: 0143505701 Enrollment ID: I20170322000001 |