| Waccamaw Medical Services, Inc. | |
|
210 Highway 87 Riegelwood NC 28456-0118 | |
| (910) 655-0021 | |
| (910) 655-2777 |
| Full Name | Waccamaw Medical Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 210 Highway 87, Riegelwood, North Carolina |
| Authorized Official Name and Position | Daniel E Boyes (ADMINISTRATOR) |
| Authorized Official Contact | 9106550021 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waccamaw Medical Services, Inc. 210 Hwy 87 Riegelwood NC 28456-0118 Ph: (910) 655-0021 | Waccamaw Medical Services, Inc. 210 Highway 87 Riegelwood NC 28456-0118 Ph: (910) 655-0021 |
| NPI Number | 1417175894 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 09/22/2008 |
| Medicare PECOS PAC ID | 5698846103 |
|---|---|
| Medicare Enrollment ID | O20080611000164 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417175894 | NPI | - | NPPES |
| 343911A | Medicaid | NC | |
| 89014 | Medicaid | NC | |
| 343911C | Medicaid | NC | |
| 1128Q | Other | NC | NC BC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |