Innovations Ridgewood | |
4801 Monticello Rd Columbia SC 29203-4124 | |
(803) 714-0266 | |
(803) 252-1968 |
Full Name | Innovations Ridgewood |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 4801 Monticello Rd, Columbia, South Carolina |
Authorized Official Name and Position | Stuart A Hamilton (CEO) |
Authorized Official Contact | 8037335969 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Innovations Ridgewood Po Box 3788 Columbia SC 29230-3788 Ph: (803) 733-5969 | Innovations Ridgewood 4801 Monticello Rd Columbia SC 29203-4124 Ph: (803) 714-0266 |
NPI Number | 1427494392 |
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Provider Enumeration Date | 05/17/2013 |
Last Update Date | 02/03/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427494392 | NPI | - | NPPES |
4350 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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