| Tidelands Health Family Medicine | |
|
1075 N Fraser St Georgetown SC 29440-2848 | |
| (843) 527-4442 | |
| (843) 527-4027 |
| Full Name | Tidelands Health Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 1075 N Fraser St, Georgetown, South Carolina |
| Authorized Official Name and Position | Elizabeth Ward (EVP & CFO) |
| Authorized Official Contact | 8435277102 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidelands Health Family Medicine Po Box 421718 Georgetown SC 29442-4203 Ph: (843) 520-8883 | Tidelands Health Family Medicine 1075 N Fraser St Georgetown SC 29440-2848 Ph: (843) 527-4442 |
| NPI Number | 1841364007 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 05/01/2020 |
| Medicare PECOS PAC ID | 2365697398 |
|---|---|
| Medicare Enrollment ID | O20141021000426 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841364007 | NPI | - | NPPES |
| RHC132 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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