Mcleod Family Medicine-Johnsonville

LBN: Mcleod Health Clarendon
Mcleod Family Medicine-Johnsonville is an health care organization with primary practice located at 355 S Georgetown Hwy , Johnsonville SC 29555-8083. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Rural Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Ambulatory Health Care Facilities / Rural Health is the primary health care specialty. Mcleod Health Clarendon can be contacted via phone (843) 380-2000, or through Ervin, Samuel Fulton via phone (843) 777-2910.

Contact Information

Primary practice address
355 S Georgetown Hwy Johnsonville SC 29555-8083
Phone: (843) 380-2000
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ervin, Samuel Fulton
Phone: (843) 777-2910

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Ambulatory Health Care Facilities / Rural Health 261QR1300X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X

Profile Details

NPI number 1144875774
LBN Legal business name Mcleod Health Clarendon
DBA Doing business as Mcleod Family Medicine-Johnsonville
Authorized official Ervin, Samuel Fulton
Entity Organization
Organization subpart 1 No
Enumeration date Aug 9th, 2019
Last updated Aug 14th, 2019 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144875774 NPPES
South Carolina MEDICAID RHC176
South Carolina Other 42-8989
South Carolina MEDICAID GP2568

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