OrganizationColonial Family Practice, LlcNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address26 Wesmark Ct, Sumter, SC 29150-1996(803) 773-5227PECOS EnrollmentBased on the most recent information from CMS, provider Colonial Family Practice, Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:14 PM.Profile DetailsProvider ID1598313827Provider TypeOrganizationFull NameColonial Family Practice, LlcSubpartNoEnumeration Date8/29/2019Last Updated8/29/2019Contact InformationPractice LocationPractice Address26 Wesmark Ct, Sumter, SC 29150-1996Phone(803) 773-5227FaxUnlisted FaxMailing LocationMailing Address325 Broad St Ste 100, Sumter, SC 29150-4167Phone(803) 773-5227Fax(803) 746-7445Authorized OfficialNameDisher, Stephanie Knight (Credentialing Specialist)Phone(803) 773-5227Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted Issuer