| One 80 Place | |
|
35 Walnut St Charleston SC 29403-4514 | |
| (843) 722-4112 | |
| Not Available |
| Full Name | One 80 Place |
|---|---|
| Speciality | Clinic/Center |
| Location | 35 Walnut St, Charleston, South Carolina |
| Authorized Official Name and Position | Aretha Jones (CEO) |
| Authorized Official Contact | 8437224112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| One 80 Place 51 Nassau St Charleston SC 29403-5513 Ph: (843) 722-4112 | One 80 Place 35 Walnut St Charleston SC 29403-4514 Ph: (843) 722-4112 |
| NPI Number | 1982124301 |
|---|---|
| Provider Enumeration Date | 06/27/2017 |
| Last Update Date | 06/27/2017 |
| Medicare PECOS PAC ID | 9032215199 |
|---|---|
| Medicare Enrollment ID | O20171006002377 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982124301 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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