Organization
SELF REGIONAL HEALTHCARE
Active
Other names
MONTGOMERY CENTER FOR FAMILY MEDICINE OF SRH
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW T LOGAN MD (PRESIDENT & CEO)
(864) 725-4253
Entity
Organization
Contact information
Practice address
155 ACADEMY AVE, GREENWOOD, SC 29646-3869
(864) 725-4865
(864) 725-4883
Mailing address
155 ACADEMY AVE, GREENWOOD, SC 29646-3808
(864) 725-4865
(864) 725-4883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
038
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CE6182
MEDICARE RR GROUP NUMBER
—
05
—
PC3251
—
SC
Enumeration date
07/18/2006
Last updated
12/14/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us