ROSA CLARK MEDICAL CLINIC ASSOCIATION, INC. – NPI #1508903394
Clinic/Center

ROSA CLARK MEDICAL CLINIC ASSOCIATION, INC. is an AHC clinic located in SENECA, SC. NPPES has assigned the NPI number 1508903394 to ROSA CLARK MEDICAL CLINIC ASSOCIATION, INC. on January 31, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “ROSA CLARK MEDICAL CLINIC ASSOCIATION, INC.” is a dba name, the actual legal business name for this organization is ROSA CLARK MEDICAL CENTER. According to the NPI Registry, there are 2 additional location(s) assigned to this provider which are listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 3 years ago on Nov 03, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ROSA CLARK MEDICAL CLINIC ASSOCIATION, INC. below.

NPI Profile for
ROSA CLARK MEDICAL CENTER

NPI Number
1508903394
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ROSA CLARK MEDICAL CENTER
Doing Business As (dba): ROSA CLARK MEDICAL CLINIC ASSOCIATION, INC.
Primary location
301 MEMORIAL DR
SENECA, SC 29672
Phone: (864) 882-4629 Fax: (864) 882-4478
2 Other location(s):
210 S Oak St
Seneca, SC 29678-3416
Phone: (864) 882-4629
Fax: (864) 882-4478
1608 E Main Street
Westminster, SC 29693
Phone: (864) 882-4629
Fax: (864) 882-4478
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JAMIE LEE
CHIEF FINANCIAL OFFICER
Phone: (864) 614-5617
Updated
Certification Date
Nov 02, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for ROSA CLARK MEDICAL CLINIC ASSOCIATION, INC.

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherPK2125083
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)
3336C0002X
- Pharmacy / Clinic Pharmacy
SC 3129
333600000X
- Pharmacy

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.