MARION MEDICAL GROUP PA NPI 1396779856

NPI Information

NPI: 1396779856
Provider Name: MARION MEDICAL GROUP PA
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
1115 N MAIN ST
MARION, SC
ZIP 29571
Phone: (843) 423-0760
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MARION MEDICAL GROUP PA is a rural health clinic center in Marion, SC. MARION MEDICAL GROUP PA NPI is 1396779856. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1115 N MAIN ST
MARION, SC
ZIP 29571-025
Phone: (843) 423-0760
Fax: (843) 423-8138

The provider's authorized official is Harold E Tucker .
The authorized official title is Chief Executive Officer and has the following contact phone number (843) 431-2405.

The enumeration date for this NPI number is 7/10/2006 and was last updated on 8/16/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine				No
2	261QR1300X	Clinic/Center	Rural Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	423852	MEDICARE ID-TYPE UNSPECIFIED	SOUTH CAROLINA
2	5117	MEDICARE PIN	SOUTH CAROLINA
3	RHC075	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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