Organization
CAROLINA HEALTH CENTERS, INC.
Active
Other names
Ware Shoals Family Practice, The Pendergrass Family Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
LISA Y GILMER (REVENUE CYCLE MANAGER)
(864) 941-8121
Entity
Organization
Contact information
Practice address
85 S GREENWOOD AVE, WARE SHOALS, SC 29692-1534
(864) 456-7436
(864) 456-2942
Mailing address
93 S GREENWOOD AVE, PO BOX 389, WARE SHOALS, SC 29692-1534
(864) 456-7436
(864) 456-2942
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FQC019
—
SC
Enumeration date
03/14/2007
Last updated
10/24/2018
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