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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