Provider Demographics
NPI:1093897183
Name:CHESTER PHYSICIANS HMA
Entity Type:Organization
Organization Name:CHESTER PHYSICIANS HMA
Other - Org Name:LOWRYS FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-581-2800
Mailing Address - Street 1:517 DOCTORS COURT
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:SC
Mailing Address - Zip Code:29706
Mailing Address - Country:US
Mailing Address - Phone:803-581-2800
Mailing Address - Fax:803-581-4396
Practice Address - Street 1:308 CHESTER AVE
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:SC
Practice Address - Zip Code:29055
Practice Address - Country:US
Practice Address - Phone:803-482-2129
Practice Address - Fax:803-482-4989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3256207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC032565Medicaid
SC032565Medicaid