# AGA SC CLINICAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457159071
- **Authorized official:** KIMBERLY RUSCH (SENIOR MANAGER OF PAYER ENROLLMENT)
- **Authorized official phone:** (706) 701-0193

## Contact information

- **Practice address:** 1010 MEDICAL CENTER DR STE 100, HARDEEVILLE, SC 29927-3452
- **Practice address phone:** (706) 548-0008
- **Practice address fax:** (706) 369-9673
- **Mailing address:** 1010 MEDICAL CENTER DR STE 100, HARDEEVILLE, SC 29927-3452
- **Mailing address phone:** (706) 548-0008
- **Mailing address fax:** (706) 369-9673

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/07/2025
- **Last updated:** 03/07/2025