Main Street Medical Pc in Hilton Head - Multi-specialty
Main Street Medical Pc - NPI 1922192194
Main Street Medical Pc is a Multi-specialty in Hilton Head, South Carolina. Main Street Medical Pc practices all healthcare services and medical treatments related to Multi-specialty. The NPI Number for Main Street Medical Pc is 1922192194. The last update date is 2020-01-15.
Main Street Medical Pc's current location address is 93 Main St, Hilton Head, South Carolina. You can contact this provider via phone number 8436813777 and fax number 8436819996. The mailing address for Main Street Medical Pc is 93 Main St, Hilton Head, South Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Main Street Medical Pc |
|---|---|
| Address | 93 Main St, Hilton Head, South Carolina |
| Phone Number | 8436813777 |
| Fax Number | 8436819996 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO DOCTOR |
|---|---|
| Authorized Official Name | Johnson Mandus Joel |
| Credentials | M.D. |
| Telephone Number | 8436813777 |
NPI Number Detail
| NPI Number | 1922192194 |
|---|---|
| Provider Enumeration Date | 2006-10-03 |
| Last Updated Date | 2020-01-15 |
Provider Mailing Address Detail
| Address | 93 Main St |
|---|---|
| City | Hilton Head |
| State | South Carolina (SC) |
| Post Code | 299261648 |
| Phone Number | 8436813777 |
| Fax Number | 8436819996 |
Provider's Primary Taxonomy Detail
| Speciality | Multi-specialty |
|---|---|
| Taxonomy | 261Qm1300X |
| Licence No | 18011 |
|
Definition: Provides integrated outpatient care across medical and surgical specialties with referrals under one roof. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 42D0940826 | SC | CLIA NUMBER | |
| 20038172 | SC | RAIL ROAD MEDICARE |
Post Comment/ Review Below
What is the Main Street Medical Pc's unique identification number?
The Main Street Medical Pc has been assigned the NPI (National Provider Identifier) Number 1922192194 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please provide the complete street address where Main Street Medical Pc is physically located?
The Main Street Medical Pc is physically situated at the following address: 93 Main St, Hilton Head, SC, 299261648.
What is the Main Street Medical Pc's area of specialization and corresponding taxonomy classification?
The Main Street Medical Pc's specialty field is Multi-specialty, and it falls under the taxonomy code 261Qm1300X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1922192194 to Main Street Medical Pc?
The Centers for Medicare & Medicaid Services originally issued the 1922192194 to Main Street Medical Pc on 2006-10-03.
As of what date were the Main Street Medical Pc's details last updated?
The information pertaining to the Main Street Medical Pc, including its address, specialty, and other details, was most recently updated on 2020-01-15.
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