Provider Demographics
NPI:1871666909
Name:HEALTHCARE MANAGEMENT GROUP, INC.
Entity Type:Organization
Organization Name:HEALTHCARE MANAGEMENT GROUP, INC.
Other - Org Name:FOWLER RURAL MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE
Authorized Official - Prefix:MR
Authorized Official - First Name:MITCH
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-423-4044
Mailing Address - Street 1:PO BOX 875
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:SC
Mailing Address - Zip Code:29571-0875
Mailing Address - Country:US
Mailing Address - Phone:843-423-4044
Mailing Address - Fax:843-423-3489
Practice Address - Street 1:2236 E HIGHWAY 76 STE B
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:SC
Practice Address - Zip Code:29571-6353
Practice Address - Country:US
Practice Address - Phone:843-423-4044
Practice Address - Fax:843-423-3489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCRHC111Medicaid
SCRHC111Medicaid