| Self Regional Healthcare | |
|
103 Little Mountain Rd Ninety Six SC 29666-9252 | |
| (864) 543-3515 | |
| Not Available |
| Full Name | Self Regional Healthcare |
|---|---|
| Speciality | Family Medicine |
| Location | 103 Little Mountain Rd, Ninety Six, South Carolina |
| Authorized Official Name and Position | Matthew Tolbert Logan (PRESIDENT & CEO) |
| Authorized Official Contact | 8647254780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Self Regional Healthcare 104 Wells Ave Greenwood SC 29646-3837 Ph: (864) 725-4673 | Self Regional Healthcare 103 Little Mountain Rd Ninety Six SC 29666-9252 Ph: (864) 543-3515 |
| NPI Number | 1619775244 |
|---|---|
| Provider Enumeration Date | 03/07/2025 |
| Last Update Date | 03/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619775244 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Self Regional Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Little Mountain Rd, Ninety Six, SC 29666 Phone: 864-543-3515 | |
Self Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Little Mountain Rd, Ninety Six, SC 29666 Phone: 864-543-3515 |