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NPI Code Detail

MEDICARE: ST. LUKE'S FREE MEDICAL CLINIC

MEDICARE: ST. LUKE'S FREE MEDICAL CLINIC
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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1124402839
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST. LUKE'S FREE MEDICAL CLINIC
Provider Business Mailing Address
First Line : PO BOX 3466
Second Line :
City : SPARTANBURG
State : SC
Zip : 29304-3466
Country : US
Telephone Number : 864-542-2273
Fax Number :
Provider Business Practice Location Address
First Line : 162 N DEAN ST
Second Line :
City : SPARTANBURG
State : SC
Zip : 29302-1517
Country : US
Telephone Number : 864-542-2273
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : PATSY WHITNEY
Credential :
Telephone Number : 864-542-2273
Provider Enumeration Date : 07/13/2015
Last Update Date : 07/13/2015

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Directions to “ST. LUKE'S FREE MEDICAL CLINIC ” Practice Location

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