Medical Outreach Clinic of Summerville Inc

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

MEDICAL OUTREACH CLINIC OF SUMMERVILLE INC

Practice address

316 W Carolina Ave
Summerville, SC 29483-4359

Phone

(843) 771-1123

Fax

(843) 771-1125

NPI assigned

Mar 8, 2018

Last updated

Mar 8, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Martin S Thomas

Title

Clinic Manager

Phone

(843) 771-1123

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520467200000",
    "number": "1942702659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WARING ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294834350",
            "telephone_number": "843-771-1123",
            "fax_number": "843-771-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 W CAROLINA AVE",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294834359",
            "telephone_number": "843-771-1123",
            "fax_number": "843-771-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL OUTREACH CLINIC OF SUMMERVILLE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-08",
        "last_updated": "2018-03-08",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "843-771-1123"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Health Clinic/Center in Summerville, SC
• Providers in Summerville, SC by specialty
• Community Health Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.