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NPI Code Detail

MEDICARE: SUPPLEMENTAL HEALTH CARE

MEDICARE: SUPPLEMENTAL HEALTH 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
1261QP2000XPhysical Therapy Clinic/Center6957SC

General Provider Information

NPI Number : 1548699366
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUPPLEMENTAL HEALTH CARE
Provider Business Mailing Address
First Line : 3462 HIGHWAY 418
Second Line :
City : FOUNTAIN INN
State : SC
Zip : 29644-4829
Country : US
Telephone Number : 864-640-9294
Fax Number :
Provider Business Practice Location Address
First Line : 4401 BELLE OAKS DR
Second Line : SUITE 280
City : N CHARLESTON
State : SC
Zip : 29405-8537
Country : US
Telephone Number : 866-571-2700
Fax Number :
Authorized Official
Title or Position : PHYSICAL THERAPIST
Name : MRS. KRISTIN GARRETT TRIPP
Credential : PT, DPT
Telephone Number : 864-640-9294
Provider Enumeration Date : 11/02/2013
Last Update Date : 11/02/2013

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Directions to “SUPPLEMENTAL HEALTH CARE ” Practice Location

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