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General NPI Number Information
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NPI Number | 1093490286
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Entity Type | Organization
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Legal Business Name | CAROLINA HEALTH CENTERS, INC.
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Dates
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Enumeration Date | 06/16/2023
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Last Update Date | 06/16/2023
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Provider Practice Location Address
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Address Line | 442 PROFESSIONAL PARK RD
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City | CLINTON
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State | SC
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Zip | 29325-7626
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Country | US
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Telephone | 864-330-8240
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Fax | 864-943-1120
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Provider Business Mailing Address
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Address Line | 313 MAIN ST STE B
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City | GREENWOOD
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State | SC
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Zip | 29646-2757
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Country | US
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Telephone | 864-330-8240
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Fax | 864-943-1120
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Authorized Official
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Title or Position | REVENUE CYCLE MANAGER
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Name | LISA Y GILMER
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Credential |
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Telephone | 864-941-8121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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