Organization
COMMUNITY MEDICINE FOUNDATION
Active
Other names
North Central Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERNEST G. BROWN (EXECUTIVE DIRECTOR)
(803) 325-7744
Entity
Organization
Contact information
Practice address
225 S HERLONG AVE, ROCK HILL, SC 29732-2730
(803) 325-7744
Mailing address
PO BOX 28, ROCK HILL, SC 29731-6028
(803) 325-8742
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
421831
MEDICARE ID
SD
01
—
4383
MEDICARE PART B
SC
05
—
CBP023
—
SC
05
—
FQC025
—
SC
Enumeration date
08/23/2011
Last updated
08/23/2011
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