Organization
GENESIS HEALTHCARE, INC.
Active
Other names
Lowcountry Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
TONY MEGNA (CEO)
(803) 254-3676
Entity
Organization
Contact information
Practice address
99 BRIDGETOWN RD, GOOSE CREEK, SC 29445-5359
(843) 572-3300
(843) 797-3331
Mailing address
8906 TWO NOTCH RD, COLUMBIA, SC 29223-6366
(803) 254-3676
(803) 254-3678
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/06/2022
Last updated
07/29/2024
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