| Main St Medical - New Ellenton Llc | |
|
735 Main St N New Ellenton SC 29809-2518 | |
| (803) 443-0077 | |
| Not Available |
| Full Name | Main St Medical - New Ellenton Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 735 Main St N, New Ellenton, South Carolina |
| Authorized Official Name and Position | Amy Young Hibbitts (OWNER) |
| Authorized Official Contact | 8036465036 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main St Medical - New Ellenton Llc 735 Main St N New Ellenton SC 29809-2518 Ph: () - | Main St Medical - New Ellenton Llc 735 Main St N New Ellenton SC 29809-2518 Ph: (803) 443-0077 |
| NPI Number | 1316762149 |
|---|---|
| Provider Enumeration Date | 11/18/2024 |
| Last Update Date | 11/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316762149 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |