| Santee Family Medical Center, Inc | |
|
130 Plaza Cir Santee SC 29142-9630 | |
| (803) 854-3940 | |
| Not Available |
| Full Name | Santee Family Medical Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 130 Plaza Cir, Santee, South Carolina |
| Authorized Official Name and Position | Gossie C. Heath Mathis (MD) |
| Authorized Official Contact | 8038543940 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Santee Family Medical Center, Inc Po Box 277 Santee SC 29142-0277 Ph: (803) 854-3940 | Santee Family Medical Center, Inc 130 Plaza Cir Santee SC 29142-9630 Ph: (803) 854-3940 |
| NPI Number | 1932427168 |
|---|---|
| Provider Enumeration Date | 05/12/2010 |
| Last Update Date | 07/09/2010 |
| Medicare PECOS PAC ID | 7315070265 |
|---|---|
| Medicare Enrollment ID | O20100729000635 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932427168 | NPI | - | NPPES |
| GP0261 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 13454 (South Carolina) | Primary |
| Provider Name | Gossie Colette Heath Mathis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295856557 PECOS PAC ID: 9436275641 Enrollment ID: I20100924001026 |
Medical Center Of Santee Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 500 Bass Drive, Santee, SC 29142 Phone: 803-854-3805 Fax: 803-854-3810 | |
Santee Family Medical Ctr Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 309 Santee River Plz, Santee, SC 29142 Phone: 803-854-3940 Fax: 803-854-3945 | |
Santee Family Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 Plaza Cir, Santee, SC 29142 Phone: 803-854-3940 Fax: 803-854-3945 |