MEDICARE: MACRO-HEALTH, INC.

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1992412175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MACRO-HEALTH, INC.

Provider Business Mailing Address
First Line	:	2432 TRUAX LN
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29204-2223
Country	:	US
Telephone Number	:	803-319-8407
Fax Number	:

Provider Business Practice Location Address
First Line	:	3305 PINE BELT RD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29204-3126
Country	:	US
Telephone Number	:	803-319-8407
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SEAN DIMARIA
Credential	:	LISW-CP
Telephone Number	:	803-319-8407

Provider Enumeration Date	:	10/28/2022
Last Update Date	:	10/28/2022

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