Provider Demographics
NPI:1790831527
Name:FLOWERTOWN MEDICAL SERVICES
Entity Type:Organization
Organization Name:FLOWERTOWN MEDICAL SERVICES
Other - Org Name:FLOWERTOWN FAMILY PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ALOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-875-1000
Mailing Address - Street 1:602 NORTH STREET
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483
Mailing Address - Country:US
Mailing Address - Phone:843-875-1000
Mailing Address - Fax:843-832-8545
Practice Address - Street 1:602 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-6627
Practice Address - Country:US
Practice Address - Phone:843-875-1000
Practice Address - Fax:843-832-8545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP2664Medicaid
SC6537Medicare ID - Type UnspecifiedGPOUP NUMBER