Organization
SANTEE FAMILY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GOSSIE C HEATH MATHIS M. D (OWNER)
(803) 854-3940
Entity
Organization
Contact information
Practice address
130 PLAZA CIR, SANTEE, SC 29142-9630
(803) 854-3940
(803) 854-3945
Mailing address
PO BOX 277, SANTEE, SC 29142-0277
(803) 854-3940
(803) 854-3945
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
13454
SC
261QP2300X
Primary Care Clinic/Center
Primary
13454
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GPO261
—
SC
Enumeration date
02/20/2008
Last updated
07/09/2010
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