2011 Provider/Pharmacy Directory - Blue Cross and Blue Shield of ...

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Medicare Blue sm and Medicare Blue sm Plus PPO Plans Provider Directory This directory provides a list of Medicare Blue and Medicare Blue Plus’ network providers. This directory is for the state of South Carolina. This directory is current as of August 1020. Some network providers may have been added or removed from the list after this directory was printed. We do not guarantee that each provider is still accepting new members. To get the most up-to-date information about Medicare Blue and Medicare Blue Plus’ network providers in your area, you can visit www.scbluesmedadvantage.com/medb11 or call our Customer Service Department at 1-888- 645-6025. From November 15, 2010 to March 1, 2011, our hours of operation are 8:00 a.m. to 8:00 p.m. Eastern Time, seven days a week. Beginning March 2, 2011, calls are handled by our automated phone system after 8:00 p.m. and on Saturdays, Sundays and holidays. TTY/TDD users should call 1-888-645-6023. Medicare Blue and Medicare Blue Plus are preferred provider organization (PPO) plans with a Medicare contract. This document is available in alternate formats. To get this information in other formats, please call 1-888-645-6025. TTY/TDD users should call 1-888-645-6023. H4209_PPO2011PPD1 CMS Approved 07272010 12925M-2011 BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association.
TABLE OF CONTENTS PROVIDER DIRECTORY Section 1 - Introduction Section 2 - List Of Plan Providers Primary Care Physicians Specialists Hospitals Skilled Nursing Facilities Outpatient Mental Health Providers Chiropractors Ancillary Providers Ambulance Service Ambulatory Surgical Center Certified Registered Nurse Anesthetist (Crna) Dialysis Centers Durable Medical Supply Company Home Health Institution Independent Laboratory Independent Physiological Laboratory Infusion Therapy Med Supply Co. With Cert. Prosthetist/Orthotis Occupational Therapy Groups Pharmacy & Dme Suppliers Physical Therapist Groups Rehabilitation Urgent Care Hospital Identifier Codes ROUTINE VISION SERVICE PROVIDERS PHARMACY DIRECTORY Section 1 - Introduction Section 2 - Network Pharmacies Retail Pharmacies Chain Pharmacies Mail Order Pharmacies iv v 1 127 392 396 402 435 453 453 455 457 457 461 470 473 474 474 474 477 477 479 488 489 492 V i Ph ii Ph 1 Ph 1 Ph 17 Ph 18 ii
Page 1: 2011 Provider/Pharmacy Directory an
Page 5 and 6: Total Network Providers Available P
Page 7 and 8: How do you find Medicare Blue and M
Page 9 and 10: AIKEN AIKEN Skinner Raymond R MD
Page 11 and 12: ANDERSON ANDERSON Donaldson Will
Page 13 and 14: ANDERSON ANDERSON Lazariashvili
Page 15 and 16: ANDERSON ANDERSON Wheeler Thomas
Page 17 and 18: BAMBERG BAMBERG Hayden John H Jr
Page 19 and 20: BEAUFORT PORT ROYAL PORT ROYAL A
Page 21 and 22: CALHOUN SAINT MATTHEWS Primary C
Page 23 and 24: CHARLESTON CHARLESTON Primary Ca
Page 25 and 26: CHARLESTON CHARLESTON Primary Ca
Page 27 and 28: Primary Care Physicians CHARLESTON
Page 29 and 30: CHEROKEE GAFFNEY Nazareno Marilu
Page 31 and 32: CLARENDON MANNING McNair Rebecca
Page 33 and 34: DARLINGTON HARTSVILLE Harless Mi
Page 35 and 36: Primary Care Physicians DORCHESTER
Page 37 and 38: FLORENCE FLORENCE Primary Care P
Page 39 and 40: GREENVILLE GREENVILLE Arashinagu
Page 41 and 42: GREENVILLE GREENVILLE Broderick
Page 43 and 44: GREENVILLE GREENVILLE Davis Lucy
Page 45 and 46: GREENVILLE GREENVILLE Garris Jef
Page 47 and 48: GREENVILLE GREENVILLE Holtzer Ka
Page 49 and 50: GREENVILLE GREENVILLE Kofoed Sha
Page 51 and 52: GREENVILLE GREENVILLE May Harry
Page 53 and 54:
GREENVILLE GREENVILLE Nithya Ram
Page 55 and 56:
GREENVILLE GREENVILLE Ray Dana R
Page 57 and 58:
GREENVILLE GREENVILLE Stanbro Ma
Page 59 and 60:
GREENVILLE GREENVILLE Williams J
Page 61 and 62:
GREENVILLE GREER Khalid Humaira
Page 63 and 64:
GREENVILLE SIMPSONVILLE Primary
Page 65 and 66:
GREENVILLE TAYLORS Primary Care
Page 67 and 68:
GREENWOOD GREENWOOD Primary Care
Page 69 and 70:
HORRY LITTLE RIVER LITTLE RIVER
Page 71 and 72:
HORRY MYRTLE BEACH Haq Ahmad T M
Page 73 and 74:
HORRY MYRTLE BEACH Tangeman Lind
Page 75 and 76:
LANCASTER FORT MILL Shah Amit G
Page 77 and 78:
LANCASTER LANCASTER Primary Care
Page 79 and 80:
LEXINGTON CHAPIN Venegas J M MD*
Page 81 and 82:
LEXINGTON IRMO Guram Surbjinder
Page 83 and 84:
LEXINGTON LEXINGTON PriceBost
Page 85 and 86:
LEXINGTON WEST COLUMBIA Primary
Page 87 and 88:
LEXINGTON WEST COLUMBIA Primary
Page 89 and 90:
NEWBERRY NEWBERRY Godoy Franco B
Page 91 and 92:
Primary Care Physicians ORANGEBURG
Page 93 and 94:
PICKENS CLEMSON Rhodes Tiffany L
Page 95 and 96:
PICKENS EASLEY Swiger Barry R MD
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RICHLAND COLUMBIA Burnham Willia
Page 99 and 100:
RICHLAND COLUMBIA Harper Greta S
Page 101 and 102:
RICHLAND COLUMBIA Joy Annarosan
Page 103 and 104:
RICHLAND COLUMBIA Nwanagu Jonath
Page 105 and 106:
RICHLAND COLUMBIA Schumacher Sar
Page 107 and 108:
RICHLAND IRMO IRMO CallisWolfe
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SPARTANBURG GREER OtubuScipio
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Primary Care Physicians SPARTANBURG
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SUMTER SUMTER Riddle Samuel M II
Page 133 and 134:
YORK YORK Thomas Aydrian L MD* F
Page 135 and 136:
AIKEN AIKEN Maniam Prakash N MD
Page 137 and 138:
ANDERSON ANDERSON ANDERSON ANDER
Page 139 and 140:
ANDERSON ANDERSON George Matthew
Page 141 and 142:
ANDERSON ANDERSON Malpass David
Page 143 and 144:
ANDERSON ANDERSON Rekito Anthony
Page 145 and 146:
ANDERSON ANDERSON Wilson Freddie
Page 147 and 148:
BARNWELL BARNWELL Patel Devesh R
Page 149 and 150:
BEAUFORT BLUFFTON Warner George
Page 151 and 152:
BEAUFORT HILTON HEAD Kalan Jay M
Page 153 and 154:
BEAUFORT HILTON HEAD Young Charl
Page 155 and 156:
BERKELEY DANIEL ISLAND O'Neill P
Page 157 and 158:
BERKELEY MONCKS CORNER Specialis
Page 159 and 160:
CHARLESTON CHARLESTON Specialist
Page 161 and 162:
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CHARLESTON MOUNT PLEASANT Specia
Page 173 and 174:
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Page 179 and 180:
Specialists CHARLESTON NORTH CHA
Page 181 and 182:
Page 183 and 184:
Page 185 and 186:
CHARLESTON SUMMERVILLE Specialis
Page 187 and 188:
CHESTER CHESTER Percival Julie A
Page 189 and 190:
COLLETON WALTERBORO COLLETON WAL
Page 191 and 192:
DARLINGTON HARTSVILLE Nwankudu N
Page 193 and 194:
DORCHESTER SUMMERVILLE Specialis
Page 195 and 196:
FLORENCE FLORENCE Bishara Lisa A
Page 197 and 198:
FLORENCE FLORENCE Jobe John S MD
Page 199 and 200:
FLORENCE FLORENCE Pande Meenaksh
Page 201 and 202:
FLORENCE LAKE CITY Palmer Susan
Page 203 and 204:
GEORGETOWN PAWLEYS ISLAND Specia
Page 205 and 206:
GREENVILLE GREENVILLE Ansari Moh
Page 207 and 208:
GREENVILLE GREENVILLE Blouin Gay
Page 209 and 210:
GREENVILLE GREENVILLE Brown Eric
Page 211 and 212:
GREENVILLE GREENVILLE Specialist
Page 213 and 214:
GREENVILLE GREENVILLE Cobb Willi
Page 215 and 216:
GREENVILLE GREENVILLE Curran Wil
Page 217 and 218:
GREENVILLE GREENVILLE Dodge Rhet
Page 219 and 220:
GREENVILLE GREENVILLE Ferlauto G
Page 221 and 222:
GREENVILLE GREENVILLE Galbraith
Page 223 and 224:
GREENVILLE GREENVILLE Gray Linda
Page 225 and 226:
GREENVILLE GREENVILLE Hayes Lloy
Page 227 and 228:
GREENVILLE GREENVILLE Horton Sam
Page 229 and 230:
GREENVILLE GREENVILLE Jervey E D
Page 231 and 232:
GREENVILLE GREENVILLE Kelly Mich
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GREENVILLE GREENVILLE Lashley Je
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GREENVILLE GREENVILLE Mabie Bill
Page 237 and 238:
GREENVILLE GREENVILLE McCarter J
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GREENVILLE GREENVILLE Merchant V
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GREENVILLE GREENVILLE Murphy R R
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GREENVILLE GREENVILLE Pace Thoma
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GREENVILLE GREENVILLE Phillips M
Page 247 and 248:
GREENVILLE GREENVILLE Riddle Cha
Page 249 and 250:
GREENVILLE GREENVILLE Sarmiento
Page 251 and 252:
GREENVILLE GREENVILLE Shusterman
Page 253 and 254:
GREENVILLE GREENVILLE Spivey Jud
Page 255 and 256:
GREENVILLE GREENVILLE Terry Lewi
Page 257 and 258:
GREENVILLE GREENVILLE Van Hale H
Page 259 and 260:
GREENVILLE GREENVILLE Welborn Ju
Page 261 and 262:
GREENVILLE GREENVILLE Wiper Dona
Page 263 and 264:
GREENVILLE GREENVILLE Young Thom
Page 265 and 266:
GREENVILLE GREER Johnson Gordon
Page 267 and 268:
GREENVILLE GREER Thompson Mauree
Page 269 and 270:
GREENVILLE SIMPSONVILLE Speciali
Page 271 and 272:
Page 273 and 274:
Page 275 and 276:
GREENWOOD GREENWOOD Specialists
Page 277 and 278:
HAMPTON VARNVILLE Lewin Albert R
Page 279 and 280:
HORRY LORIS Pande Amit V MD* Car
Page 281 and 282:
HORRY MYRTLE BEACH Dean Mark T O
Page 283 and 284:
HORRY MYRTLE BEACH Lee David B P
Page 285 and 286:
HORRY MYRTLE BEACH Sloan Frank K
Page 287 and 288:
JASPER HARDEEVILLE Coolidge Caro
Page 289 and 290:
KERSHAW CAMDEN Olatosi Akinwale
Page 291 and 292:
LANCASTER LANCASTER Makhuli Mark
Page 293 and 294:
LAURENS CLINTON Yu Henry MD* Nep
Page 295 and 296:
LEXINGTON COLUMBIA Miller Stewar
Page 297 and 298:
LEXINGTON IRMO O'Leary James A M
Page 299 and 300:
LEXINGTON LEXINGTON Hydorn Chris
Page 301 and 302:
LEXINGTON WEST COLUMBIA Speciali
Page 303 and 304:
Page 305 and 306:
Page 307 and 308:
Page 309 and 310:
MARLBORO BENNETTSVILLE Specialis
Page 311 and 312:
OCONEE SENECA Carter George E II
Page 313 and 314:
ORANGEBURG NORTH NORTH Tharp Sho
Page 315 and 316:
ORANGEBURG ORANGEBURG Specialist
Page 317 and 318:
ORANGEBURG ORANGEBURG Specialist
Page 319 and 320:
PICKENS EASLEY Edenfield William
Page 321 and 322:
PICKENS PICKENS PICKENS Spearman
Page 323 and 324:
RICHLAND COLUMBIA Boyd Robert E
Page 325 and 326:
RICHLAND COLUMBIA Carroll Vernon
Page 327 and 328:
RICHLAND COLUMBIA Deemer Jessamy
Page 329 and 330:
RICHLAND COLUMBIA Gabr Usama A M
Page 331 and 332:
RICHLAND COLUMBIA Hawsey Laura A
Page 333 and 334:
RICHLAND COLUMBIA Jones Benjamin
Page 335 and 336:
RICHLAND COLUMBIA Lovern Mark A
Page 337 and 338:
RICHLAND COLUMBIA McLaughlin Nia
Page 339 and 340:
RICHLAND COLUMBIA Norman Jennife
Page 341 and 342:
RICHLAND COLUMBIA Rafiq Muhammad
Page 343 and 344:
RICHLAND COLUMBIA Shenoy Rajeev
Page 345 and 346:
RICHLAND COLUMBIA Thompson Steph
Page 347 and 348:
RICHLAND COLUMBIA Wells John A J
Page 349 and 350:
SPARTANBURG BOILING SPRINGS Spec
Page 351 and 352:
SPARTANBURG GREER Kallman David
Page 353 and 354:
SPARTANBURG INMAN Penka Rachelle
Page 355 and 356:
SPARTANBURG SPARTANBURG Speciali
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SUMTER SUMTER Moses Henry P MD*
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UNION UNION Wren John D MD* Path
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YORK ROCK HILL Blackwell James B
Page 395 and 396:
YORK ROCK HILL Khandekar Suresh
Page 397 and 398:
YORK ROCK HILL Reuter Robert MD
Page 399 and 400:
ABBEVILLE ABBEVILLE ABBEVILLE AB
Page 401 and 402:
HORRY LORIS HORRY LORIS Loris Co
Page 403 and 404:
AIKEN AIKEN AIKEN AIKEN Carriage
Page 405 and 406:
FAIRFIELD RIDGEWAY FAIRFIELD RID
Page 407 and 408:
LEXINGTON WEST COLUMBIA Skilled
Page 409 and 410:
AIKEN AIKEN Outpatient Mental He
Page 411 and 412:
BEAUFORT BEAUFORT Outpatient Men
Page 413 and 414:
Outpatient Mental Health Providers
Page 415 and 416:
Page 417 and 418:
Page 419 and 420:
Page 421 and 422:
Page 423 and 424:
Page 425 and 426:
Page 427 and 428:
HORRY MYRTLE BEACH Outpatient Me
Page 429 and 430:
LEXINGTON COLUMBIA Outpatient Me
Page 431 and 432:
NEWBERRY NEWBERRY Outpatient Men
Page 433 and 434:
RICHLAND COLUMBIA Outpatient Men
Page 435 and 436:
Page 437 and 438:
Page 439 and 440:
Page 441 and 442:
YORK ROCK HILL Munson Catherine
Page 443 and 444:
ANDERSON BELTON Chiropractors BE
Page 445 and 446:
CHARLESTON CHARLESTON Chiropract
Page 447 and 448:
CHESTER CHESTER Hardin Lyles G D
Page 449 and 450:
GEORGETOWN ANDREWS GEORGETOWN AN
Page 451 and 452:
GREENVILLE GREER GREER Kemp Moni
Page 453 and 454:
LEXINGTON CHAPIN Nelson Matthew
Page 455 and 456:
PICKENS EASLEY Naumann Victoria
Page 457 and 458:
SPARTANBURG SPARTANBURG Chiropra
Page 459 and 460:
YORK ROCK HILL Muschik Jeffery M
Page 461 and 462:
LEXINGTON WEST COLUMBIA Ancillar
Page 463 and 464:
GREENVILLE GREENVILLE Greenville
Page 465 and 466:
CHESTER CHESTER BMA Of Chester 5
Page 467 and 468:
FAIRFIELD WINNSBORO Fresenius Me
Page 469 and 470:
GREENVILLE GREENVILLE Adam Medic
Page 471 and 472:
Ancillary Providers GEORGETOWN P
Page 473 and 474:
GEORGETOWN GEORGETOWN Ancillary
Page 475 and 476:
Page 477 and 478:
RICHLAND COLUMBIA University Med
Page 479 and 480:
DORCHESTER SUMMERVILLE Ancillary
Page 481 and 482:
CHARLESTON CHARLESTON Ancillary
Page 483 and 484:
LANCASTER LANCASTER Hanger Prost
Page 485 and 486:
ANDERSON PIEDMONT Carolina Oxyge
Page 487 and 488:
Page 489 and 490:
HORRY MYRTLE BEACH Ancillary Pro
Page 491 and 492:
RICHLAND COLUMBIA Ancillary Prov
Page 493 and 494:
OCONEE SENECA The Weston Group I
Page 495 and 496:
SUMTER SUMTER Ancillary Provider
Page 497 and 498:
Ancillary Providers CHARLESTON M
Page 499 and 500:
Routine Vision Service Providers Th
Page 501 and 502:
vision-care providers abbeville abb
Page 503 and 504:
vision-care providers pendleton For
Page 505 and 506:
vision-care providers appel, Gary s
Page 507 and 508:
vision-care providers criswell, Mic
Page 509 and 510:
vision-care providers dungan, Willi
Page 511 and 512:
vision-care providers Hopkins, Jose
Page 513 and 514:
vision-care providers ray, tracy p
Page 515 and 516:
vision-care providers kershaw Mcdow
Page 517 and 518:
vision-care providers Mcelveen, kar
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vision-care providers easley bible,
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vision-care providers lowry Gary, b
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vision-care providers vastis, nicko
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vision-care providers Younger, Will
Page 527 and 528:
vision-care providers Mazhari, nima
Page 529 and 530:
Introduction This booklet provides
Page 531 and 532:
ABBEVILLE Calhoun Falls Callaway’
Page 533 and 534:
Retail Pharmacies Low Country Medic
Page 535 and 536:
Retail Pharmacies Ladson Piggly Wig
Page 537 and 538:
Retail Pharmacies Med Center Ltc Ph
Page 539 and 540:
Retail Pharmacies Timmonsville Timm
Page 541 and 542:
Retail Pharmacies Taylors Taylors D
Page 543 and 544:
Retail Pharmacies Mobley Drugs 1073
Page 545 and 546:
Retail Pharmacies Marlboro Drug Com
Page 547 and 548:
Retail Pharmacies The Medicine Mart
Page 549 and 550:
Retail Pharmacies Inman Kempson Rex
Page 551 and 552:
Retail Pharmacies Community Medicin
Page 553 and 554:
Long-Term Care Pharmacies HoRRy Lor
Page 555 and 556:
Home Infusion Pharmacies Medicare B
Page 557 and 558:
Indian Health Service/Tribal/ Urban
Page 559 and 560:
Provider Index 3 3D Medical Suppl
Page 561 and 562:
Provider Index Anguelova, Ivo V MD
Page 563 and 564:
Provider Index Belle, Larry J LISW
Page 565 and 566:
Provider Index Bozeman, Elizabeth W
Page 567 and 568:
Provider Index CallisWolfe, Rache
Page 569 and 570:
Provider Index Chillag, Kim J MD 28
Page 571 and 572:
Provider Index Cropper, Leland D MD
Page 573 and 574:
Provider Index DHEC Region II Home
Page 575 and 576:
Provider Index Edens, Gregory MD 86
Page 577 and 578:
Provider Index Fisher, Courtney M M
Page 579 and 580:
Provider Index Gandhi, Mukesh M MD
Page 581 and 582:
Provider Index Greer, Richard C MD
Page 583 and 584:
Provider Index Health Care Product
Page 585 and 586:
Provider Index Houston, Robert E MD
Page 587 and 588:
Provider Index Joglekar, Rajiv MD 5
Page 589 and 590:
Provider Index Kinard, John A Jr MD
Page 591 and 592:
Provider Index Leavitt, Anna T MD 8
Page 593 and 594:
Provider Index Macmillan, James P I
Page 595 and 596:
Provider Index McDonald, Jacquelyn
Page 597 and 598:
Provider Index Mims, William W Jr M
Page 599 and 600:
Provider Index Nechodom, Oonagh M F
Page 601 and 602:
Provider Index Palma, David T MD 23
Page 603 and 604:
Provider Index Phillips, Michael S
Page 605 and 606:
Provider Index Rankin, Howard J PhD
Page 607 and 608:
Provider Index Rogers, Richard L Sr
Page 609 and 610:
Provider Index Scott, Brian S MD 65
Page 611 and 612:
Provider Index Smith, Desmond E MD
Page 613 and 614:
Provider Index Stout, Donald M MD 1
Page 615 and 616:
Provider Index Timmons, Gloria H ED
Page 617 and 618:
Provider Index Vermillion, Stephen
Page 619 and 620:
Provider Index Whiteaker, Roberta G
Page 621:
Provider Index Yuko, Ronald T MD 25
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2011 Provider/Pharmacy Directory - Blue Cross and Blue Shield of ...

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