Provider Demographics
NPI:1184637902
Name:AMERICARE HEALTH, PC
Entity Type:Organization
Organization Name:AMERICARE HEALTH, PC
Other - Org Name:FAMILY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCIAL CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ABIMBOLA
Authorized Official - Last Name:EDOSOMWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-535-0400
Mailing Address - Street 1:905 N PEARL ST
Mailing Address - Street 2:
Mailing Address - City:PAGELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29728-1522
Mailing Address - Country:US
Mailing Address - Phone:843-672-3100
Mailing Address - Fax:843-672-3102
Practice Address - Street 1:905 N PEARL ST
Practice Address - Street 2:
Practice Address - City:PAGELAND
Practice Address - State:SC
Practice Address - Zip Code:29728-1522
Practice Address - Country:US
Practice Address - Phone:843-672-3100
Practice Address - Fax:843-672-3102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC207Q00000X, 207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC002GOtherPROVIDER ID#
SCSC-GP1785Medicaid
NCNC790515TMedicaid
SCSC-GP1785Medicaid