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Zandria Darcel Fredrick

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

Sc House Calls Inc., 111 Doctors Cir., Columbia, SC 29203

PECOS Enrollment

This provider is enrolled in PECOS as ZANDRIA FREDRICK.

Based on the most recent information from CMS, provider Zandria Darcel Fredrick is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1265079263
Provider Type
Individual
Full Name
Fredrick, Zandria Darcel
Credential
APRN

Gender
Female
Sole Proprietor
No
Enumeration Date
12/9/2019
Last Updated
1/31/2024

Contact Information

Practice Location

Sc House Calls Inc., 111 Doctors Cir., Columbia, SC 29203

(800) 491-0909

(803) 376-5885

Mailing Location

Sc House Calls Inc., 111 Doctors Cir., Columbia, SC 29203

(800) 491-0909

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 23477 South Carolina

Provider Identifiers

ID	Description	Issuer
ID NP6537	Description Medicaid	Issuer Unlisted South Carolina

Zandria Darcel Fredrick

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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