Organization
GENESIS HEALTH CARE, INC
Active
Organization
GENESIS HEALTH CARE, INC
Active
Other names
Valcourt Pediatrics Assoc.
Organization subpart
No
Provider details
NPI number
Authorized official
TONY MEGNA (CEO)
(803) 254-3676
Entity
Organization
Contact information
Practice address
124 MEDICAL PARK DR, WALTERBORO, SC 29488-5719
(803) 782-3636
Mailing address
8906 TWO NOTCH RD, COLUMBIA, SC 29223-6366
(803) 254-3676
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
11/27/2018
Last updated
01/24/2022
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