MEDICARE: EXPRESS MEDICAL CARE

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
1	261QU0200X	Urgent Care Clinic/Center	17193	SC

Other Identifiers

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

General Provider Information

NPI Number	:	1497771919
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXPRESS MEDICAL CARE

Provider Business Mailing Address
First Line	:	2049 SAVANNAH HWY
Second Line	:	SUITE D
City	:	CHARLESTON
State	:	SC
Zip	:	29407-2228
Country	:	US
Telephone Number	:	843-852-0551
Fax Number	:	843-852-0552

Provider Business Practice Location Address
First Line	:	2049 SAVANNAH HWY
Second Line	:	SUITE D
City	:	CHARLESTON
State	:	SC
Zip	:	29407-2228
Country	:	US
Telephone Number	:	843-852-0551
Fax Number	:	843-852-0552

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. ROBERT JOHN SPARANO
Credential	:	M.D.
Telephone Number	:	843-852-0551

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	08/22/2020

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Directions to “EXPRESS MEDICAL CARE ” Practice Location

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