| True Vine Health Services, Inc | |
|
1773 Village Park Dr Orangeburg SC 29118-2475 | |
| (803) 535-3600 | |
| Not Available |
| Full Name | True Vine Health Services, Inc |
|---|---|
| Speciality | General Practice |
| Location | 1773 Village Park Dr, Orangeburg, South Carolina |
| Authorized Official Name and Position | Katrina Jamison (COO) |
| Authorized Official Contact | 8035353600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| True Vine Health Services, Inc 1773 Village Park Dr Orangeburg SC 29118-2475 Ph: (803) 535-3600 | True Vine Health Services, Inc 1773 Village Park Dr Orangeburg SC 29118-2475 Ph: (803) 535-3600 |
| NPI Number | 1255186631 |
|---|---|
| Provider Enumeration Date | 04/19/2024 |
| Last Update Date | 04/19/2024 |
| Medicare PECOS PAC ID | 4789122680 |
|---|---|
| Medicare Enrollment ID | O20240809001790 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255186631 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Monnieque Singleton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336193713 PECOS PAC ID: 8426968587 Enrollment ID: I20031211000062 |
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