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Organization
CAROLINA HEALTH CENTERS, INC.
Active
Organization
CAROLINA HEALTH CENTERS, INC.
Active
Other names
Ware Shoals Family Practice, The Pendergrass Family Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
LISA Y GILMER (REVENUE CYCLE MANAGER)
(864) 941-8121
Entity
Organization
Contact information
Practice address
85 S GREENWOOD AVE, WARE SHOALS, SC 29692-1534
(864) 456-7436
(864) 456-2942
Mailing address
93 S GREENWOOD AVE, PO BOX 389, WARE SHOALS, SC 29692-1534
(864) 456-7436
(864) 456-2942
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FQC019
—
SC
Enumeration date
03/14/2007
Last updated
10/24/2018
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