ROSA CLARK MEDICAL CENTER (NPI# 1508903394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508903394 |
| Entity Type | Organization |
| Organization Name | ROSA CLARK MEDICAL CENTER |
| Other Organization Name | ROSA CLARK MEDICAL CLINIC ASSOCIATION, INC. |
| Practice Address |
301 Memorial Dr Seneca SC 29672 |
| Mailing Address |
301 Memorial Dr Seneca SC 29672-9491 |
| Practice Telephone | 8648824629 |
| Practice Fax Number | 8648824478 |
| Mailing Telephone | 8648824629 |
| Mailing Fax Number | 8648824478 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2019-08-12 |
| Authorized Official Name | VICKI THOMPSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8648824664 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
3129 | SC | Suppliers |
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2125083 | 01 |
| Other Name | Type Code |
|---|---|
| Rosa Clark Medical Clinic Association, Inc. | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 210 S Oak St, Seneca, SC 296783416 | 8648824629 | 8648824478 |
| Street Address |
301 MEMORIAL DR |
| City | SENECA |
| State | SC |
| Zip Code | 29672 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609215136 | William Moore Beam II | Internal Medicine | 301 Memorial Dr, Suite F, Seneca, SC 29672-9491 | 2013-06-18 |
| 1992910210 | Oconee Physician Practices | Contractor | 301 Memorial Dr, Suite G, Seneca, SC 29672-9491 | 2007-05-11 |
| 1992812507 | Kenneth H. Becker | Family Medicine | 301 Memorial Dr, Suite F, Seneca, SC 29672-9491 | 2006-08-23 |
| 1720079544 | Wendy Sue Manzon | Internal Medicine | 301 Memorial Dr, Suite F, Seneca, SC 29672-9491 | 2005-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790308955 | Pooja Kamboj | Student in an Organized Health Care Education/Training Program | 139 Lila Doyle Dr., Seneca, SC 29672 | 2020-05-22 |
| 1578126785 | Johanna Marie Scarino Lemons | Lactation Consultant, Non-RN | 504 Willow Branch Ln, Seneca, SC 29672 | 2019-04-15 |
| 1982067971 | Marthe Melanie Bryant Connah | Family Medicine | 139 Lila Doyle Drive, Family Medicine Residency - Oconee, Seneca, SC 29672 | 2016-03-29 |
| 1558733220 | Alyssa K. Locke | Occupational Therapist | 101 S-37-349, Seneca, SC 29672 | 2015-10-21 |
| 1497857742 | Pulmonary Critical Care & Sleep Associates Pa | Clinic/Center | 107 Omni Drive, Suite A, Seneca, SC 29672 | 2006-09-05 |
| 1659381440 | Timothy Aaron Zeller | Family Medicine | 139 Lila Doyle Dr, Seneca, SC 29672 | 2006-08-08 |
| 1871546978 | Samuel Thomas Drake | Specialist | 103 Omni Dr Ste A, Seneca, SC 29672 | 2006-05-18 |
| 1235123878 | Nancy Matz Thiel | Chiropractor | 355 Katelynn Lane, Seneca, SC 29672 | 2005-09-09 |
| 1265439954 | David E Heape | Emergency Medicine | 298 Memoral Drive, Oconee Memorial Hospital, Seneca, SC 29672 | 2005-07-07 |
| 1407345846 | Prisma Health-upstate | Clinic/Center | 139 Lila Doyle Drive, Seneca, SC 29672 | 2018-05-01 |
| Find all providers in zip 29672 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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|---|---|---|---|---|
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| 1922584481 | Sandhills Medical Foundation, Inc. | Clinic/Center | 290 Market Street, Ruby, SC 29741 | 2018-07-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.