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NPI Code Detail

MEDICARE: TANDEM HEALTH SC

MEDICARE: TANDEM HEALTH SC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386630192
Entity Type Code : Organization
Provider Name (Legal Business Name) : TANDEM HEALTH SC
Provider Business Mailing Address
First Line : 1278 N LAFAYETTE DR
Second Line :
City : SUMTER
State : SC
Zip : 29150-2964
Country : US
Telephone Number : 803-774-4500
Fax Number : 803-774-4650
Provider Business Practice Location Address
First Line : 1278 N LAFAYETTE DR
Second Line :
City : SUMTER
State : SC
Zip : 29150-2964
Country : US
Telephone Number : 803-774-4500
Fax Number : 803-774-4627
Authorized Official
Title or Position : CEO
Name : MS. ANNIE B BROWN
Credential :
Telephone Number : 803-774-4500
Provider Enumeration Date : 09/27/2005
Last Update Date : 10/14/2019

Similar Medicare Providers

1932059888 — MRS. TENIKQUA FULLWOOD-MAPLE PMHNP-BC
Practice Location Address:
1278 N LAFAYETTE DR
SUMTER, SC
29150-2964
Practice Phone: 803-774-4500
Practice Fax:
1821812462 — GABRYEL SANTOS PA-C
Practice Location Address:
1278 N LAFAYETTE DR
SUMTER, SC
29150-2964
Practice Phone: 803-774-4500
Practice Fax:
1972596302 — KATHERINE SAUNDERS MN PNP
Practice Location Address:
1278 N LAFAYETTE DR
SUMTER, SC
29150-2964
Practice Phone: 803-774-4500
Practice Fax: 803-774-4627
1407849805 — BARBARA DEASE LMSW
Practice Location Address:
1278 N LAFAYETTE DR
SUMTER, SC
29150-2964
Practice Phone: 803-774-4500
Practice Fax: 803-774-4627
1598758922 — RICHARD LEE DENNY MD
Practice Location Address:
1278 N LAFAYETTE DR
SUMTER, SC
29150-2964
Practice Phone: 803-774-4500
Practice Fax: 803-774-4627
1508859927 — RUSSELL V BRANT MD
Practice Location Address:
1278 N LAFAYETTE DR
SUMTER, SC
29150-2964
Practice Phone: 803-774-4500
Practice Fax: 803-974-4627

Directions to “TANDEM HEALTH SC ” Practice Location

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