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2021 South Carolina Provider Directory Directorio de Proveedores de South Carolina

This directory is updated as of 02/03/2021.

Chesterfield, Darlington, Dillon, Florence, Horry, Marion, Marlboro, Williamsburg

Proudly serving Healthy Connections members.

CAD_68840M State Approved 06132019 ©WellCare 2021 SC1SMDDIR68840M_00PE 38642781 38642781

TABLE OF CONTENTS

Provider Directory Introduction ...... I How to Read Our Provider Listings ...... II Icon Guide ...... II

List of Plan Providers Primary Care Physicians Chesterfield ...... 1 Darlington ...... 2 Dillon ...... 6 Florence ...... 7 Horry ...... 13 Marion ...... 24 Marlboro ...... 25 Williamsburg ...... 26 Specialty Physicians Chesterfield ...... 27 Darlington ...... 30 Dillon ...... 38 Florence ...... 45 Horry ...... 81 Marion ...... 121 Marlboro ...... 123 Williamsburg ...... 124 Hospitals Chesterfield ...... 126 Darlington ...... 127 Dillon ...... 128 Florence ...... 129 Horry ...... 130 Marion ...... 131 Williamsburg ...... 132 Ancillary Providers All ...... 133 Chesterfield ...... 134 Darlington ...... 135 Dillon ...... 136 Florence ...... 137 Horry ...... 141

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TABLE OF CONTENTS

Ancillary Providers Marion ...... 149 Marlboro ...... 150 Williamsburg ...... 151 Allied Providers Chesterfield ...... 152 Darlington ...... 153 Dillon ...... 158 Florence ...... 160 Horry ...... 179 Marion ...... 227 Marlboro ...... 228 Williamsburg ...... 231 Pharmacy Chesterfield ...... 232 Darlington ...... 233 Dillon ...... 234 Florence ...... 235 Horry ...... 237 Marion ...... 241 Marlboro ...... 242 Williamsburg ...... 243

Indexes Alternate Languages Index ...... 244 Specialty Providers At-A-Glance ...... 247 Extended Hours Index ...... 252 Provider Index ...... 261 38642781

Here is your WellCare of South Carolina provider directory. It lists all of the providers in our network. These providers include:

• Primary care providers (PCPs) and specialists • Hospitals • Pharmacies

Each of these providers will make his or her own decisions about the care you need. WellCare of South Carolina is not responsible for these decisions. Some providers may not perform certain services due to their religious or moral beliefs. We’ve listed all of the providers by county. Then we’ve grouped them together by the type of care or services they give. We’ve also included: • The providers’ addresses and phone numbers • Symbols to tell you whether the provider is accepting new patients, board certified or wheelchair accessible We have a provider look-up tool on our website. Go to www.wellcare.com/South-Carolina. Then click on the “Find a Provider” icon. You’ll be able to search for providers right in your area. This is the best place to get our most current directory information. Call us if you have questions about this directory. We can help you find a provider. We can even help set up an appointment for you. Our toll-free number is 1-888-588-9842. TTY users can call 711. You can reach us Monday - Friday, 8 a.m. to 6 p.m. We wish you good health.

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How to Read Our Provider Listings

Indicates provider is board certified Indicates provider has wheelchair access Provider name Smith, Joe, MD Provider ID: 111111 Accessible by Public Practice name Your Family Medical Center Transportation Provider gender Male/Female Indicates provider is not Provider 123 Main Street accepting new patients address and { Anytown, FL 12345 phone number (555) 555-5555 00 Yrs/99 Yrs Ages of patients seen by provider Sunshine Hospital Hospital the provider is associated with Language: Spanish Language spoken by provider or staff Cultural Competence Training Indicates whether or not provider has Complete/Incomplete completed Cultural Competence Training 9:00 am-5:00 pm Hours of operation PCMH: YES/NO. Level 1, 2, 3 Takes part in the PCMH* Model

Icon Guide

Indicates provider is board certified

Indicates provider has wheelchair access

Indicates provider is not accepting new patients

Accessible by Public Transportation

*PCMH stands for Patient Centered Medical Home. This is a way of giving care that involves a team of healthcare professionals. The team works together to meet the needs of each patient. Providers are placed in one of three levels; Level 1 (lowest), Level 2 and Level 3 (highest). www.wellcare.com/South-Carolina | II 38642781

Este es su directorio de proveedores de WellCare of South Carolina. Aquí se listan todos los proveedores en nuestra red. Estos proveedores incluyen:

• Proveedores de cuidado primario (PCP) y especialistas • Hospitales • Farmacias Cada uno de estos proveedores tomará sus propias decisiones sobre el cuidado que usted necesita. WellCare of South Carolina no es responsable de esas decisiones. Es posible que algunos proveedores no proporcionen ciertos servicios debido a sus creencias religiosas o morales. Hemos listado a todos los proveedores por condado. Luego los hemos agrupado por el tipo de cuidado o servicios que ofrecen. También hemos incluido:

• Las direcciones y los números de teléfono de los proveedores • Símbolos para indicarle si el proveedor está aceptando nuevos pacientes, si es certificado por una junta o si cuenta con acceso para silla de ruedas En nuestro sitio web contamos con una herramienta de búsqueda de proveedores. Visite www.wellcare.com/South-Carolina. Luego haga clic en el icono “Find a Provider” (Buscar un proveedor). Usted podrá buscar proveedores exactamente en su área. Este es el mejor lugar para obtener nuestra información de directorio más actual. Si tiene alguna pregunta sobre este directorio, llámenos. Podemos ayudarle a encontrar un proveedor. Incluso podemos ayudarle a programar una cita. Nuestro número sin cargo es 1-888-588-9842. Los usuarios de TTY pueden llamar al 711. Puede comunicarse con nosotros de lunes a viernes de 8 a.m. a 6 p.m. Le deseamos una buena salud.

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Cómo leer nuestros listados de proveedores

Indica que el proveedor es certificado por la junta médica Indica que el proveedor tiene acceso para silla de ruedas

Nombre del proveedor Smith,Joe, MD Provider ID: 111111 Accesible en Nombre de la práctica Your Family Medical Center transporte público Sexo del proveedor Male/Female Indica que el proveedor no está Dirección y número 123 Main Street aceptando a nuevos pacientes de teléfono del {Anytown, FL 12345 proveedor (555) 555-5555 00 Yrs/99 Yrs Edades de los pacientes vistos por el proveedor Sunshine Hospital Hospital con el que está asociado el proveedor Language: Spanish Idioma que habla el proveedor o personal Cultural Competence Training Indica si el proveedor completó o no la Complete/Incomplete capacitación de competencia cultural 9:00 am-5:00 pm Horario de atención PCMH: YES/NO. Level 1, 2, 3 Participa en el modelo PCMH*

Guía de íconos

Indica que el proveedor es certificado por la junta médica

Indica que el proveedor tiene acceso para silla de ruedas

Indica que el proveedor no está aceptando a nuevos pacientes

Accesible en transporte público

*PCMH se refiere a Hogar Médico Enfocado en el Paciente. Es una manera de proporcionar cuidado que involucra a un equipo de profesionales de la salud. El equipo trabaja en conjunto para satisfacer las necesidades de cada paciente. Los proveedores son asignados a uno de tres niveles: Nivel 1 (el más bajo), Nivel 2 y Nivel 3 (el más alto). www.wellcare.com/South-Carolina | IV 38642781

Spanish to English Provider Types*/Tipos de proveedores de español a inglés*

Español Inglés Español Inglés Acupuntura Acupuncture Electrofisiología Cardiac Psiquiatría de Addiction Psychiatry cardíaca Electrophysiology adicciones Monitoreo cardíaco Cardiac Monitoring Medicina para Adolescent Cardiología Cardiology adolescentes Medicine Cirugía Cardiovascular Servicios de Adult Companion cardiovascular Surgery acompañante para Services adultos Cirugía Cardiovascular cardiovascular Surgery Cuidado diurno para Adult Day Care adultos Servicios de Case Management administración Services Hogar de cuidado Adult Foster Care de casos sustituto para Home adultos Pediatría de abuso Child Abuse infantil Pediatrics Cuidado médico Adult Medical Day diurno para adultos Care Centro de desarrollo Child Development para niños Center Cuidado residencial Adult Residential para adultos Care Home Administración de Children Targeted casos enfocados Case Management Administración de Adult Targeted Case en niños casos enfocados Management en adultos Niños con Children With Centro para tratar AIDS Center necesidades Special Health Care el SIDA especiales de Needs cuidado de la salud Alergias e Allergy & inmunología Immunology Quiropráctica Chiropractic Centro de cirugía Ambulatory Surgery Servicios de tareas Chore/ ambulatoria Center domésticas y Housekeeping limpieza del hogar Services Servicios de vida Assisted Living asistida Services Clínica Clinic Audiología Audiology Neurofisiología Clinical clínica Neurophysiology Asesoramiento Behavioral Health en salud del Counseling Cirugía de colon Colon & Rectal comportamiento y recto Surgery Centro de salud del Behavioral Health Centro de salud Community Health comportamiento Facility comunitario Center Centro de Birthing Center Centro de salud Community Mental maternidad mental comunitario Health Center Laboratorio de Cardiac Cath Junta de servicios Community Service cateterismo cardíaco Laboratory a la comunidad Board

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Español Inglés Español Inglés Cirugía cardíaca Congenital Cardiac Planificación familiar Family Planning congénita Surgery Medicina familiar Family Practice Servicios de Consumable Medical suministros médicos Supply Services Servicios de Family Training descartables capacitación familiar Services Clínica de cuidado Convenient Care Centro de salud con Federally Qualified conveniente Clinic calificación federal Health Center Hospital de acceso Critical Access Servicios de Financial Risk crítico Hospital evaluación/reducción Assessment/Risk de riesgos financieros Reduction Services Odontología Dentistry Centro de aptitud Fitness Center Dermatología Dermatology física Dermatopatología Dermatopathology Gastroenterología Gastroenterology Centro designado Designated Aids Gastroenterología Gastroenterology & para el sida Center y hepatología Hepatology Educación sobre Diabetes Education Medicina general General Practice la diabetes Cirugía general General Surgery Centro de diagnóstico Diagnostic And y tratamiento Treatment Center Asesoramiento Genetic Counseling Centro de diagnóstico Diagnostic Center genético Diagnóstico por Diagnostic Imaging Medicina geriátrica Geriatric Medicine imágenes Psiquiatría geriátrica Geriatric Psychiatry Diálisis Dialysis Oncología Gynecological Equipo médico Durable Medical ginecológica Oncology duradero Equipment Ginecología Gynecology Otorrinolaringología Ear, Nose & Throat Cirugía de la mano Hand Surgery Endocrinología, Endocrinology, Oncología de cabeza Head & Neck diabetes, Diabetes, Metabolism y cuello Oncology metabolismo Cirugía de cabeza Head & Neck Surgery Endodoncia Endodontics y cuello Servicios de Environmental Control de la Health Safety adaptaciones de Accessibility seguridad de la salud Monitoring accesibilidad al Adaptation Services entorno Proveedor de Hearing Aid Supplier audífonos Servicios especiales de EPSDT Special EPSDT Services Terapia y especialista Hearing Aid Therapy & en audífonos Specialist Servicios de Escort Services acompañante Hematología Hematology

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Español Inglés Español Inglés Hematología Hematology & Diagnóstico con Mobile Diagnostic y oncología Oncology equipos portátiles VIH/SIDA HIV/AIDS MRI, equipos abiertos MRI Open Comidas entregadas Home-Delivered Medicina perinatal Neonatal Perinatal a domicilio Meals neonatal Medicine Cuidado de la salud Home Healthcare Nefrología Nephrology en el hogar Neurooncología Neuro Oncology Hospicio Hospice Discapacidades Neurodevelopmental Cuidado de hospicio Hospice & Palliative del desarrollo Disabilities y paliativo Care neurológico Hospital Hospital Neurodiagnóstico Neurodiagnostic Servicios de limpieza Housekeeping/ Neurología Neurology del hogar y tareas Chore Services Neurología/otología Neurology/Otology domésticas Medicina Neuromuscular Medicina hiperbárica Hyperbaric Medicine neuromuscular Medicine Enfermedades Infectious Disease Neurooncología Neuro-Oncology infecciosas Neuropsicología Neuropsychology Terapia de infusión Infusion Therapy Neurorradiología Neuroradiology Medicina interna Internal Medicine Neurocirugía Neurosurgery Pruebas de Laboratory Servicios de Non-Emergency laboratorio de Pathology Testing transporte sin Transportation patología carácter de Agencia licenciada de Licensed Home Care emergencia servicios de cuidado Service Agency Cardiología nuclear Nuclear Cardiology en el hogar Medicina nuclear Nuclear Medicine Litotripsia Lithotripsy Radiología nuclear Nuclear Radiology Imágenes por Magnetic Resonance resonancia Imaging Enfermeras parteras Nurse Midwife magnética Nutrición Nutrition Mamografía Mammography Obstetricia Obstetrics Masoterapia Massage Therapy Obstetricia/ Obstetrics/ Ginecología Gynecology Medicina Maternal Fetal maternofetal Medicine Medicina Occupational ocupacional Medicine Genética médica Medical Genetics Terapia ocupacional Occupational Oncología médica Medical Oncology Therapy Administración de Medication Oftalmología Ophthalmology medicamentos Administration

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Español Inglés Español Inglés Óptico Optician Hematología/ Pediatric Hematology/ oncología pediátricas Oncology Optometría Optometry Cirugía oral y Oral & Maxillofacial Enfermedades Pediatric Infectious maxilofacial Surgery infecciosas pediátricas Disease Ortodoncia Orthodontics Nefrología pediátrica Pediatric Nephrology Cirugía ortopédica Orthopaedic Surgery Neurología pediátrica Pediatric Neurology Ortésica Orthotics Neurocirugía Pediatric Ortopedia y Orthotics & pediátrica Neurosurgery prostética Prosthetics Oncología pediátrica Pediatric Oncology Establecimiento Outpatient Surgical Oftalmología Pediatric quirúrgico para Facility pediátrica Ophthalmology pacientes ambulatorios Ortopedia pediátrica Pediatric Orthopaedics Tratamiento del Pain Management Cirugía ortopédica Pediatric Orthopedic dolor pediátrica Surgery Apoyo para el Pain Management Psiquiatría pediátrica Pediatric Psychiatry tratamiento del Support dolor Neumonología Pediatric Pulmonology pediátrica Alergias e inmunología Pediatric Allergy pediátricas & Immunology Medicina de Pediatric Rehabilitation rehabilitación Medicine Medicina pediátrica Pediatric Behavioral pediátrica del comportamiento Medicine Reumatología Pediatric Monitoreo cardíaco Pediatric Cardiac pediátrica Rheumatology pediátrico Monitoring Medicina deportiva Pediatric Sports Cardiología pediátrica Pediatric Cardiology pediátrica Medicine Cirugía cardiovascular Pediatric pediátrica Cardiovascular Surgery Cirugía pediátrica Pediatric Surgery Dermatología Pediatric Dermatology Hepatología pediátrica Pediatric Transplant pediátrica y trasplante Hepatology Otorrinolaringología Pediatric Ear, Nose Urología pediátrica Pediatric Urology pediátrica & Throat Pediatría Pediatrics Endocrinología Pediatric pediátrica Endocrinology Comportamiento y Pediatrics Behavioral & desarrollo pediátrico Developmental Gastroenterología Pediatric pediátrica Gastroenterology Pedodoncia Pedodontics Genética pediátrica Pediatric Genetics Periodoncia Periodontics

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Español Inglés Español Inglés Servicios de cuidado Personal Care Centro de Rehabilitation Facility personal Services rehabilitación Servicios personales Personal Emergency Medicina de Rehabilitation de respuesta de Response System rehabilitación Medicine emergencias Terapia de Rehabilitation rehabilitación Therapy Farmacia Pharmacy Endocrinología Reproductive Medicina física Physical Medicine reproductiva Endocrinology y rehabilitación & Rehabilitation Terapia respiratoria Respiratory Therapy Terapia física Physical Therapy Servicios de cuidado Respite Care Services Laboratorio de Physiological Lab de relevo fisiología Reumatología Rheumatology Cirugía plástica y Plastic & Centro de salud rural Rural Health Center reconstructiva Reconstructive Surgery Cuidado autodirigido Self-Directed Care Podiatría Podiatry Centro de enfermería Skilled Nursing Facility especializada Medicina preventiva Preventive Medicine Estudios de Sleep Diagnostic Centro de cuidado Primary Care Center diagnóstico del sueño Studies primario Medicina del sueño Sleep Medicine Aparatos protésicos Prosthetics Cuidado diurno social Social Day Care Prostodoncia Prosthodontics Psiquiatría Psychiatry Terapia del habla Speech Therapy Psicología Psychology Medicina para Spinal Cord Injury lesiones de médula Medicine Medicina Psychosomatic espinal psicosomática Medicine Medicina deportiva Sports Medicine Enfermedad Pulmonary Disease Cuidado subagudo Sub-Acute Care pulmonar Oncología Radiation Oncology Abuso de sustancias Substance Abuse radioterápica Oncología quirúrgica Surgical Oncology Radioterapia Radiation Therapy Monitoreo Tele-Cardiac Centro de Radiation Therapy telecardíaco Monitoring radioterapia Center Cirugía torácica Thoracic & y cardiovascular Cardiovascular Radiología Radiology - Surgery intervencional Interventional & y vascular Vascular Cirugía torácica Thoracic Surgery

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Español Inglés Español Inglés Tórax/sistema Thoracic/Vascular Oncología urológica Urology Oncology vascular Urología/ginecología Urology/Gynecology Hepatología de Transplant trasplante Hepatology Laboratorio vascular Vascular Lab Centro de cuidado Urgent Care Center Medicina vascular Vascular Medicine urgente Cirugía vascular Vascular Surgery Urología Urology

* These are only some of the provider types. You can find a specific kind of provider in the Specialty Index. It can be found in the back of this book. * Estos son solo algunos de los tipos de proveedores. Usted puede encontrar un tipo específico de proveedor en el Índice de especialidades que encontrará en la parte posterior de este libro.

www.wellcare.com/South-Carolina | X Main

South Carolina Regional Map Mapa regional de South Carolina

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List of Plan Providers Lista de proveedores del plan 38642781

Primary Care Providers Chesterfield Family Practice Federally Qualified Health Center Barton, Garrett MD Biester, Christina MD Provider ID: 1645139 Provider ID: 769529 Gender: Male Gender: Male Mcleod Family Medicine Cheraw Csc Chesterfield 710 Chesterfield Hwy Subspecialty: HRSA FQHC Cheraw, SC 29520-7001 500 West Blvd (843) 537-2171 Chesterfield, SC 29709-1402 Fax: (843) 537-5926 (843) 623-5080 Mon - Fri 8:00 to 5:00 Fax: (843) 623-5081 PCMH: No Mon - Fri 8:30 to 5:00 PCMH: No Barton, Kinzie MD Provider ID: 1695889 Internal Medicine Gender: Female Palmetto Family Medicine Of Edosomwan, Emmanuel MD Chester Provider ID: 900896 316 2nd St Gender: Male Cheraw, SC 29520-2404 Americare Health Pageland (843) 921-4851 905 N Pearl St Fax: (843) 921-4854 Pageland, SC 29728-1522 Mon - Thu 8:00 to 5:00 (843) 672-3100 Fri 8:00 to 1:00 Fax: (843) 672-3102 PCMH: No Mon - Fri 9:00 to 5:00 Sat 9:00 to 2:00 PCMH: No Biester, Christina MD Provider ID: 769529 Gender: Male Pediatrics Csc Chesterfield Schultz, Agnes MD Subspecialty: HRSA FQHC Provider ID: 768131 500 West Blvd Gender: Female Chesterfield, SC 29709-1402 Cheraw Pediatrics P A (843) 623-5080 119 Chesterfield Hwy Fax: (843) 623-5081 Cheraw, SC 29520-7113 Mon - Fri 8:30 to 5:00 (843) 537-1811 PCMH: No Fax: (843) 537-1802 Mon - Fri 8:30 to 5:00 Novinger, Travis MD PCMH: No Provider ID: 1033712 Gender: Male Thomas, Jude MD Palmetto Family Medicine Provider ID: 1346885 316 2nd St Gender: Male Cheraw, SC 29520-2404 Mcleod Pediatrics Cheraw (843) 921-4851 723 S Doctors Dr Fax: (843) 921-4854 Cheraw, SC 29520-7108 Mon - Fri 8:00 to 5:00 (843) 537-9360 PCMH: No Fax: (843) 537-9710 Mon - Fri 8:00 to 5:00 PCMH: No

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Primary Care Providers Darlington Family Practice Conner, Daniel DO Harless, Michael MD Provider ID: 2041207 Provider ID: 1304735 Ambrose, Michael MD Gender: Male Gender: Male Provider ID: 769348 Caresouth Carolina Inc. Hartsville Medical Associates LLC Gender: Male 1268 S 4th St 206 Swift Creek Rd The Medical Group Hartsville, SC 29550-0703 Hartsville, SC 29550 701 Medical Park Dr, Ste 302303 (843) 332-3422 (843) 917-4117 Hartsville, SC 29550 Mon - Fri 8:30 to 5:00 Fax: (843) 917-4590 (843) 383-5191 PCMH: No Mon - Fri 8:00 to 5:00 Fax: (843) 383-4142 PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No Davis, William MD Provider ID: 767349 Lilly, Douglass MD Gender: Male Provider ID: 862996 Barrett, Michael MD Hartsville Medical Group LLC Gender: Male Provider ID: 1648429 701 Medical Park Dr, Ste 300 Mcleod Family Medicine Darlington Gender: Male Hartsville, SC 29550-4779 701 Cashua Ferry Rd Genesis Health Care Inc DBA Lamar (843) 383-5191 Darlington, SC 29532-8488 F Fax: (843) 383-4142 (843) 777-7072 301 W Main St Mon - Fri 9:00 to 5:00 Fax: (843) 398-7028 Lamar, SC 29069-7102 PCMH: No Mcleod Medica Center Darlington (843) 395-8400 Mcleod Regional Medical Center Fax: (803) 254-3678 Mon - Fri 8:00 to 5:00 Mon - Thu 8:00 to 5:00 Dickinson, Thomas MD PCMH: No Fri 8:00 to 12:00 Provider ID: 769287 PCMH: No Gender: Male Mcleod Urgent Care Darlington Long, William MD 964 Lochend Dr Provider ID: 1314260 Bell, Thomas MD Darlington, SC 29532-5698 Gender: Male Provider ID: 768352 (843) 777-6890 Palmetto Family Medicine And Gender: Male Fax: (843) 777-6891 Senior The Medical Group Mon - Fri 8:00 to 9:00 420 W Carolina Ave 701 Medical Park Dr, Ste 305 Sat 9:00 to 4:00 Hartsville, SC 29550 Hartsville, SC 29550-4779 Sun 11:00 to 4:00 (843) 917-4977 (843) 339-3040 PCMH: No Fax: (888) 854-0390 Fax: (843) 656-1073 Mon - Fri 8:00 to 5:00 Mon - Fri 9:00 to 5:00 PCMH: No PCMH: No Elder, Robert MD Provider ID: 1304737 Gender: Male Martin, William MD Cohen, Alexander MD Hartsville Medical Associates LLC Provider ID: 1579514 Provider ID: 1254796 206 Swift Creek Rd Gender: Male Gender: Male Hartsville, SC 29550 Hartsville Medical Group LLC Genesis Healthcare Inc DBA Lamar (843) 917-4117 701 Medical Park Dr, Ste 207 301 W Main St Fax: (843) 917-4590 Hartsville, SC 29550-4778 Lamar, SC 29069 Mon - Fri 8:00 to 5:00 (843) 383-5171 (843) 395-8410 PCMH: No Fax: (843) 332-9229 Fax: (843) 395-8401 Mon - Fri 8:30 to 5:00 Mon - Thu 8:00 to 5:00 PCMH: No Fri 8:00 to 12:00 PCMH: No

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Primary Care Providers Darlington Family Practice - cont. Ropp, John MD Sponseller, Brian MD Provider ID: 1308912 Provider ID: 1580150 Mendez, Luz MD Gender: Male Gender: Male Provider ID: 1304736 Palmetto Family Medicine And Hartsville Medical Group LLC Gender: Female Senior 701 Medical Park Dr, Ste 207 Hartsville Medical Associates LLC 420 W Carolina Ave Hartsville, SC 29550-4778 206 Swift Creek Rd Hartsville, SC 29550 (843) 383-5171 Hartsville, SC 29550 (843) 917-4968 Fax: (843) 332-9229 (843) 917-4117 Fax: (888) 854-0390 Mon - Fri 8:00 to 5:00 Fax: (843) 917-4590 Mon - Fri 8:00 to 5:00 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Washington, Tonya MD Scharstein, Jeffrey MD Provider ID: 1812257 Mendoza Olivero, Isabel MD Provider ID: 768569 Gender: Female Gender: Male Hartsville Medical Group LLC Provider ID: 1260982 Mcleod Family Medicine Of 1304 W Bobo Newsom Hwy Gender: Female Darlingto Hartsville, SC 29550-4710 Lamar 701 Cashua Ferry Rd (843) 383-5191 301 W Main St, Ste A Darlington, SC 29532 Fax: (843) 383-6456 Lamar, SC 29069-7102 (843) 777-7058 Mon - Fri 8:00 to 5:00 (843) 395-8410 Fax: (843) 391-2028 PCMH: No Fax: (843) 395-8401 Mon - Fri 8:00 to 5:00 Mon - Thu 8:00 to 5:00 PCMH: No Fri 8:00 to 12:00 Welch, Priscilla MD PCMH: No Provider ID: 769352 Sherwin, David MD Gender: Female Provider ID: 2234413 Pee Dee Healthcare Owens, Daniel MD Gender: Male 201 Cashua St Provider ID: 901362 Musc Physicians Primary Care Darlin Darlington, SC 29532 Gender: Male 301 Pearl St (843) 396-9730 Mcleod Family Medicine Darlington Darlington, SC 29532-3812 Fax: (843) 395-8435 701 Cashua Ferry Rd (843) 413-6891 Mon - Fri 9:00 to 5:00 Darlington, SC 29532 Mon - Fri 8:00 to 5:00 PCMH: No (843) 398-8500 PCMH: No Fax: (843) 391-2039 Mon - Fri 8:00 to 5:00 General Practice PCMH: No Sponseller, Kevin MD Provider ID: 1271725 Mcinnis, James MD Gender: Male Provider ID: 1311540 Powell, Joseph MD The Medical Group Gender: Male Provider ID: 767554 701 Medical Park Dr, Ste 207 Pee Dee Healthcare Gender: Male Hartsville, SC 29550 201 Cashua St The Medical Group (843) 656-1200 Darlington, SC 29532 701 Medical Park Dr, Ste 305 Fax: (843) 332-9229 (843) 393-7452 Hartsville, SC 29550 Mon - Fri 8:00 to 5:00 Fax: (843) 393-6210 (843) 339-3040 PCMH: No Mon - Fri 8:00 to 5:00 Fax: (843) 332-2240 PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No

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Primary Care Providers Darlington Internal Medicine Senseney, Anna MD Japitana, Marian MD Provider ID: 1607198 Provider ID: 1230985 Chapman, Raymond MD Gender: Female Gender: Female Provider ID: 768932 Hartsville Medical Group LLC The Childrens Group P C Gender: Male 701 Medical Park Dr, Ste 304 604 N 5th St Hartsville Medical Group LLC Hartsville, SC 29550-4779 Hartsville, SC 29550-3212 701 Medical Park Dr, Ste 305 (843) 383-0713 (843) 332-6645 Hartsville, SC 29550-4779 Fax: (843) 656-1076 Fax: (843) 332-9894 (843) 383-5191 Mon - Fri 8:00 to 5:00 Carolina Pines Regional Medical Fax: (843) 656-1194 PCMH: No Center Mon - Fri 9:00 to 5:00 Mon - Fri 8:30 to 5:00 PCMH: No Pediatrics Sat 9:00 to 11:00 PCMH: No Heaster, Brian MD Bardi, Christopher MD Provider ID: 767477 Provider ID: 767350 Keith, John MD Gender: Male Gender: Male Provider ID: 767024 Genesis Healthcare Inc Eastern Carolina Pediatrics PC Gender: Male 201 Cashua St 105 Industrial Way Eastern Carloina Pediatrics PC Darlington, SC 29532 Darlington, SC 29532-0000 105 Industrial Way (843) 393-7452 (843) 395-0015 Darlington, SC 29532 Fax: (843) 393-6210 Fax: (843) 667-6791 (843) 395-0015 Mon - Fri 8:00 to 5:00 Mon - Fri 8:30 to 5:00 Fax: (843) 393-0971 PCMH: No PCMH: No Mon - Fri 8:30 to 5:00 PCMH: No Maqsood, Farhan MD Budhram, Solomon MD Provider ID: 769154 Provider ID: 768434 Morphis, James MD Gender: Male Gender: Male Provider ID: 768497 Hartsville Medical Group LLC Childrens Group PC Gender: Male 701 Medical Park Dr, Suite 302 303 604 N 5th St Morphis Pediatric Group Hartsville, SC 29550-4777 Hartsville, SC 29550-3212 708 Medical Park Dr (843) 383-3634 (843) 332-6645 Hartsville, SC 29550 Fax: (843) 383-4142 Fax: (843) 332-9894 (843) 332-5121 Mon - Fri 9:00 to 5:00 Carolina Pines Regional Medical Fax: (843) 332-0993 PCMH: No Center Carolina Pines Regional Medical Mon - Fri 8:30 to 5:00 Center Sat 9:00 to 11:00 Mon - Sat 8:30 to 5:00 Reynolds, Susan MD PCMH: No Provider ID: 767483 Sun 12:30 to 5:00 Gender: Female PCMH: No The Medical Group Davis, Richard MD 701 Medical Park Dr, Ste 304 Provider ID: 769350 Morphis, Elizabeth MD Hartsville, SC 29550-4779 Gender: Male Provider ID: 769066 (843) 383-5191 Eastern Carolina Pediatrics Pa Gender: Female Fax: (843) 332-9125 105 Industrial Way Morphis Ped Group Mon - Fri 9:00 to 5:00 Darlington, SC 29532 708 Medical Park Dr PCMH: No (843) 395-0015 Hartsville, SC 29550 Fax: (843) 667-6791 (843) 332-5121 Mon - Fri 8:30 to 5:00 Fax: (843) 332-0993 PCMH: No Carolina Pines Regional Medical Center Musc Lancaster Medical Center Mon - Fri 9:00 to 12:00 PCMH: No

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Primary Care Providers Darlington Pediatrics - cont. Morphis, Elizabeth MD Provider ID: 769066 Gender: Female 1304 W Bobo Newsom Hwy Hartsville, SC 29550-4710 (843) 339-2100 Carolina Pines Regional Medical Center Musc Lancaster Medical Center PCMH: No

Ovanna Budhram, Joni MD Provider ID: 769318 Gender: Female Childrens Group PC 604 N 5th St Hartsville, SC 29550-3212 (843) 332-6645 Fax: (843) 332-9894 Carolina Pines Regional Medical Center Mon - Fri 8:30 to 5:00 Sat 9:00 to 11:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 5 38642781

Primary Care Providers Dillon Family Practice Internal Medicine Obstetrics/Gynecology Fitzgibbon, Timothy MD Kelly, James MD Brooks, Melissa MD Provider ID: 768189 Provider ID: 912227 Provider ID: 996098 Gender: Male Gender: Female Gender: Female Dillon Family Medicine Pa Dillon Internal Medicine Associates Mcleod OBGYN Dillon 603 N 6th Ave 705 N 8th Ave, Ste 1a 706 N 8th Ave Dillon, SC 29536 Dillon, SC 29536-2549 Dillon, SC 29536-2549 (843) 774-7336 (843) 774-2478 (843) 841-3825 Fax: (843) 774-3745 Fax: (843) 774-0293 Fax: (843) 841-3830 Mon - Fri 8:00 to 6:00 Mon - Fri 8:30 to 5:00 Mon - Fri 8:00 to 5:00 Sat 9:00 to 12:00 PCMH: No PCMH: No PCMH: No Odin, Alto DO Pediatrics Freel, Paul MD Provider ID: 1801218 Provider ID: 768393 Gender: Male Ramirez, Yvonne MD Gender: Male Dillon Internal Medicine Associates Provider ID: 769332 Dillon Family Medicine Pa 705 N 8th Ave, Ste 1a Gender: Female 603 N 6th Ave Dillon, SC 29536-2549 Mcleod Physician Associates II Dillon, SC 29536 (843) 774-2478 705 N 8th Ave, Ste 3a (843) 774-7336 Fax: (843) 774-0293 Dillon, SC 29536-2549 Fax: (843) 774-7331 Mon, Wed - Fri 8:30 to 5:00 (843) 774-6091 Mon - Fri 8:00 to 6:00 Tue 8:30 to 12:00 Fax: (843) 841-3814 PCMH: No PCMH: No Mon - Thu 9:00 to 5:00 Fri 8:30 to 5:00 Sat 9:00 to 2:30 Shealy, Robin MD Wallace, James MD PCMH: No Provider ID: 767210 Provider ID: 1801930 Gender: Female Gender: Male Dillon Family Medicine Pa Dillon Internal Medicine Associates Wangeh, Joseph MD 603 N 6th Ave 705 N 8th Ave, Ste 1a Provider ID: 821326 Dillon, SC 29536 Dillon, SC 29536-2549 Gender: Male (843) 774-7336 (843) 774-2478 Mcleod Pediatrics Dillon Fax: (843) 774-9942 Fax: (843) 774-0293 705 N 8th Ave, Ste 3a Mon - Fri 8:00 to 6:00 Mon - Tue, Thu - Fri 8:30 to 5:00 Dillon, SC 29536 Sat 9:00 to 12:00 Wed 8:30 to 1:00 (843) 774-6091 PCMH: No PCMH: No Fax: (843) 841-3814 Mon - Fri 9:00 to 5:00 PCMH: No Vance, Stephen MD Wallace, James MD Provider ID: 767209 Provider ID: 912226 Gender: Male Gender: Male Dillon Family Medicine Pa Dillon Internal Medicine Associates 603 N 6th Ave 705 N 8th Ave, Ste 1a Dillon, SC 29536 Dillon, SC 29536-2549 (843) 774-7336 (843) 774-2478 Fax: (843) 774-3745 Fax: (843) 774-0293 Mon - Fri 8:00 to 6:00 Mon - Fri 8:30 to 5:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 6 38642781

Primary Care Providers Florence Family Practice Barrett, Michael MD Brown, Morris MD Provider ID: 768573 Provider ID: 769275 Alexander, Clarence MD Gender: Male Gender: Male Provider ID: 767222 Jeter Skinner Family Practice Lake City Family Medicine Gender: Male 101 S Ravenel St, Ste 160 901 N Matthews Rd Medical Plaza Family Medicine Florence, SC 29506 Lake City, SC 29560-7024 800 E Cheves St, Ste 310 (843) 662-1533 (843) 374-8380 Florence, SC 29506-2652 Fax: (843) 679-7273 Fax: (843) 374-5247 (843) 679-7272 Mon - Wed 8:30 to 5:00 Lake City Community Hospital Fax: (843) 679-7215 Thu - Fri 9:00 to 5:00 Mon - Fri 8:00 to 4:30 Mon - Fri 9:00 to 5:00 PCMH: No PCMH: No PCMH: No Beeraka, Prakash MD Cohen, Alexander MD Angus, Joslyn MD Provider ID: 770741 Provider ID: 919501 Provider ID: 769753 Gender: Male Gender: Male Gender: Male Mcleod Oncology And Hematology Genesis Health Care Inc Jeter Skinner Family Practice Asso 211 S Jones Rd 101 S Ravenel St, Ste 160 101 S Ravenel St, Ste 160 Olanta, SC 29114-9705 Florence, SC 29506 Florence, SC 29506-2635 (843) 393-7452 (843) 662-1533 (843) 662-1533 Fax: (843) 395-8435 Fax: (843) 679-7273 Fax: (843) 679-7273 Mon - Fri 8:00 to 5:00 Mon - Wed 8:30 to 5:00 Mon - Fri 8:30 to 5:00 PCMH: No Thu - Fri 9:00 to 5:00 PCMH: No PCMH: No Dickinson, Thomas MD Behling, Donald MD Provider ID: 769287 Artis Bacote, Karen NP Provider ID: 768084 Gender: Male Provider ID: 1849507 Gender: Male Mcleod Urgent Care Center Gender: Female Medical Plaza Family Medicine 3015 W Palmetto St Musc Physicians Express Care 800 E Cheves St, Ste 310 Florence, SC 29501-5935 Floren Florence, SC 29506 (843) 777-6870 1925 Hoffmeyer Rd (843) 679-7272 Fax: (843) 777-6871 Florence, SC 29501 Fax: (843) 679-7215 Mon - Fri 8:00 to 8:00 (843) 413-6925 Mon - Fri 8:00 to 5:00 Sat - Sun 9:00 to 4:00 Musc Health Florence Medical PCMH: No PCMH: No Center Mon - Fri 2:00 to 10:00 Sat 9:00 to 6:00 Brown, Traesa MD Faile, Kenneth MD PCMH: No Provider ID: 1640140 Provider ID: 769124 Gender: Female Gender: Male Select Family Medicine LLC Mcleod Family Medicine Of John- Azizzadeh, Naceme DO 312 S Mcqueen St sonvi Provider ID: 1286616 Florence, SC 29501-4723 355 S Georgetown Hwy Gender: Female (843) 799-2978 Johnsonville, SC 29555 144 N Ravenel Street Fax: (843) 799-2980 (843) 380-2000 Florence, SC 29506 Mon - Thu 8:00 to 5:00 Fax: (843) 380-2014 (843) 777-2800 Fri 8:00 to 12:00 Mon - Fri 9:00 to 5:00 Fax: (843) 777-2810 PCMH: No PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 7 38642781

Primary Care Providers Florence Family Practice - cont. Ignacio, Iris MD Jebaily, Patrick MD Provider ID: 1207985 Provider ID: 814518 Haskill Strowd, Rebecca MD Gender: Male Gender: Male Musc Physicians Pee Dee Primary Medical Plaza Family Medicine Provider ID: 1802998 Car 800 E Cheves St, Ste 310 Gender: Female 1594 Freedom Blvd, Ste C202 Florence, SC 29506 Mcleod Primary Care Associates Florence, SC 29505 (843) 679-7272 800 E Cheves St, Ste 200 (843) 664-9696 Fax: (843) 679-7215 Florence, SC 29506-2651 Fax: (843) 629-7029 Mon - Fri 9:00 to 5:00 (843) 777-9190 Musc Health Florence Medical PCMH: No Fax: (843) 679-7273 Center Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No Lamb, Benjamin MD PCMH: No Provider ID: 766831 Gender: Male Hicks, Ashley MD Jackson, Kimberly MD Musc Physicians Primary Care Lake Provider ID: 2049133 Provider ID: 1445505 C Gender: Female Gender: Female 148 Sauls St, Ste C Musc Physicians Primary Care Mcleod Primary Care Associates Lake City, SC 29560-2677 Hoffme 800 E Cheves St, Ste 200 (843) 374-3621 1925 Hoffmeyer Rd Florence, SC 29506-2651 Fax: (843) 355-3624 Florence, SC 29501-4011 (843) 662-1502 Musc Health Florence Medical (843) 679-4214 Fax: (843) 678-3611 Center Fax: (843) 679-4217 Mon - Thu 8:30 to 5:00 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fri 8:30 to 12:00 PCMH: No PCMH: No PCMH: No Macdonald, Allan MD Hoffmeyer, Margaret MD Jackson-Dozier, Focell MD Provider ID: 767621 Provider ID: 767459 Provider ID: 901063 Gender: Male Gender: Female Gender: Female Mcleod Family Medicine Center Hoffmeyer Margaret H Mcleod Family Practice Of 555 E Cheves St 125 S Cashua Dr Timmonsvi Florence, SC 29506 Florence, SC 29501-4001 755 E Smith St (843) 777-2800 (843) 667-3273 Timmonsville, SC 29161-9430 Fax: (843) 777-5350 Fax: (843) 667-8876 (843) 346-3900 Mon - Fri 8:30 to 5:00 Mon - Fri 9:00 to 5:00 Fax: (843) 346-7839 PCMH: No PCMH: No Mon - Thu 7:00 to 5:00 Fri 7:00 to 12:00 Mattheis, John MD Howell, Richard MD PCMH: No Provider ID: 766961 Provider ID: 777454 Gender: Male Gender: Male Jebaily, Gerard MD Mcleod Family Medicine Center Mcleod Family Medicine Center Provider ID: 768595 555 E Cheves St 555 E Cheves St Gender: Male Florence, SC 29506 Florence, SC 29506 Mcleod Family Medicine Center (843) 777-2800 (843) 777-2800 144 N Ravenel St Fax: (843) 777-5350 Fax: (843) 777-5350 Florence, SC 29506 Mon - Fri 8:30 to 5:00 Mon - Fri 8:30 to 5:00 (843) 777-2800 PCMH: No PCMH: No Fax: (843) 777-2810 Mon - Fri 8:30 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 8 38642781

Primary Care Providers Florence Family Practice - cont. Morris, Judy NP Rowson, Abraham MD Provider ID: 1849581 Provider ID: 2395445 Mcclary, Guy MD Gender: Female Gender: Male Provider ID: 956708 Musc Physicians Express Care Musc Physicians Gender: Male Floren 1925 Hoffmeyer Road Medical Plaza Family Medicine 1925 Hoffmeyer Rd, Ste 100 Florence, SC 29501 800 E Cheves St, Ste 310 Florence, SC 29501-4011 (843) 679-4214 Florence, SC 29506-2652 (842) 413-6925 Fax: (843) 679-4217 (843) 679-7272 Musc Health Florence Medical Mon - Fri 8:00 to 5:00 Fax: (843) 679-7215 Center PCMH: No Mon - Fri 8:00 to 5:00 Mon - Fri 2:00 to 10:00 PCMH: No Sat 9:00 to 6:00 PCMH: No Samaha, Anne MD Provider ID: 897086 Mims, Albert MD Gender: Female Provider ID: 768630 Paschal, Hudnall MD Musc Physicians Primary Care Gender: Male Provider ID: 904343 Hoffme Musc Physicians Primary Care Lake Gender: Male 1925 Hoffmeyer Rd C Musc Physicians Pee Dee Primary Florence, SC 29501-4011 148 Sauls St, Ste C Car (843) 679-4214 Lake City, SC 29560-2631 1594 Freedom Blvd, Ste C202 Fax: (843) 679-4217 (843) 374-3621 Florence, SC 29505-6046 Musc Health Florence Medical Fax: (843) 699-9518 (843) 664-9696 Center Musc Health Florence Medical Fax: (843) 629-7229 Mon - Fri 8:00 to 5:00 Center Musc Health Florence Medical PCMH: No Mon - Fri 8:00 to 5:00 Center PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Shelton, Heather MD Provider ID: 769667 Mohr, Richard MD Gender: Female Provider ID: 768004 Reynolds, Brandie MD Mcleod Family Medicine South Gender: Male Provider ID: 1067705 611 2nd Loop Rd Mcleod Family Medicine Gender: Female Florence, SC 29505-2820 555 E Cheves St Musc Physicians Primary Care (843) 777-9460 Florence, SC 29506 Pampli Fax: (843) 678-3610 (843) 777-2800 953 S Pamplico Hwy Mon - Fri 8:00 to 5:00 Fax: (843) 777-5350 Pamplico, SC 29583 PCMH: No Mon - Fri 9:00 to 5:00 (843) 493-5252 PCMH: No Fax: (843) 493-2372 Musc Health Florence Medical Smith, Cory MD Center Provider ID: 768279 Mohr III, Richard MD Gender: Male Provider ID: 2240104 Mon - Fri 8:00 to 5:00 PCMH: No Medical Plaza Family Medicicne Gender: Male 800 E Cheves St, Ste 310 Family Medicine And Mohr Florence, SC 29506-2652 1505 Heritage Ln, # A Rowson, Abraham MD (843) 679-7272 Florence, SC 29505-3141 Provider ID: 1260945 Fax: (843) 679-7215 (843) 407-9010 Gender: Male Mon - Fri 9:00 to 5:00 Fax: (847) 407-9032 Cornerstone Primary Care LLC PCMH: No Mon - Thu 8:00 to 5:00 2500 Hoffmeyer Rd Fri 8:00 to 12:00 Florence, SC 29501-7407 PCMH: No (843) 665-0102 Fax: (843) 665-0026 Mon - Thu 8:00 to 5:00 Fri 8:00 to 1:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 9 38642781

Primary Care Providers Florence Family Practice - cont. General Practice Heaster, Brian MD Provider ID: 767478 Stanley, Christopher MD Mcinnis, James MD Gender: Male Provider ID: 1629824 Provider ID: 1311538 Genesis Healthcare Inc Gender: Male Gender: Male 211 S Jones Rd Mcleod Orthopaedics- Florence Olanta Family Care Olanta, SC 29114-9705 1005 E Cheves St 211 S Jones Rd (843) 396-9730 Florence, SC 29506-2707 Olanta, SC 29114 Fax: (803) 403-9570 (843) 777-7900 (843) 396-9730 Mon - Thu 8:00 to 5:00 Fax: (843) 777-7925 Fax: (843) 396-9735 Fri 8:00 to 12:00 Mon - Fri 8:00 to 5:00 Mon - Thu 8:00 to 5:00 PCMH: No PCMH: No Fri 8:00 to 12:00 PCMH: No Maroney, Constance MD Steadman, Mark MD Provider ID: 2279835 Provider ID: 772299 Internal Medicine Gender: Female Gender: Male Adabala, Nivedita MD Mcleod Internal Medicine Associ- Musc Physicians Pee Dee Primary ates Car Provider ID: 1838402 Gender: Female 800 E Cheves St, Ste 400 1594 Freedom Blvd, Ste C202 Florence, SC 29506-2649 Florence, SC 29505-6046 Mcleod Regional Medical Center 555 E Cheves St (843) 777-7341 (843) 664-9696 Fax: (843) 777-7345 Fax: (843) 669-1668 Florence, SC 29506-2617 (843) 777-5240 Mon - Fri 9:00 to 5:00 Musc Health Florence Medical PCMH: No Center Fax: (843) 777-5572 Mon - Fri 8:00 to 5:00 Mon - Sun 12:00 to 12:00 PCMH: No PCMH: No Moore, Ellen MD Provider ID: 1289779 Gender: Female Strickland, Stephanie MD Anyim, Alecia MD Provider ID: 1362208 Mcmcleod Primary Care Associates Provider ID: 1147034 800 E Cheves St, Ste 200 Gender: Female Gender: Female Genesis Health Care Inc. Florence Florence, SC 29506 Mcleod Family Medicine South (843) 662-1502 611 2nd Loop Rd 1523 Heritage Ln, Unit B Florence, SC 29505-3197 Fax: (843) 777-7345 Florence, SC 29505-2820 Mon - Thu 8:00 to 5:00 (843) 777-9460 (843) 673-0900 Fax: (843) 665-5851 Fri 8:00 to 12:00 Fax: (843) 678-3610 PCMH: No Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Myers, Jocelyn MD Provider ID: 1503626 Williams, Ryan DO Donato, Eduardo MD Provider ID: 900495 Gender: Female Provider ID: 1710515 Five Star Diagnostics LLC Gender: Male Gender: Male Musc Physicians Primary Care 555 E Cheves St. Florence Family Medicine Florence, SC 29506 315 N Beltline Dr, Ste E Floren 1594 Freedom Blvd, Ste C102 (803) 318-2072 Florence, SC 29501-7420 Fax: (205) 449-5031 (843) 407-8192 Florence, SC 29505-6046 (843) 679-4221 Mon - Fri 8:00 to 5:00 Fax: (866) 421-2723 PCMH: No Mon - Fri 8:00 to 5:00 Fax: (843) 679-4268 PCMH: No Musc Health Florence Medical Center Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 10 38642781

Primary Care Providers Florence Internal Medicine - cont. Davis, Richard MD Graham, Toney MD Provider ID: 769350 Provider ID: 768865 Quaye, Emmanuel MD Gender: Male Gender: Male Provider ID: 1345186 805 Pamplico Hwy, Ste A220 Grahams Clinic Gender: Male Florence, SC 29505-6050 1278 Moore St Magnolia Healthcare Inc (843) 674-5000 Lake City, SC 29560 619 S Dargan St PCMH: No (843) 389-7251 Florence, SC 29506 Fax: (843) 389-7253 (843) 432-2502 Mon 7:00 to 6:00 Fax: (843) 799-1392 Davis, Richard MD Tue - Wed, Fri 7:00 to 5:00 Mon - Fri 9:00 to 5:00 Provider ID: 769351 Thu 7:00 to 1:00 PCMH: No Gender: Male PCMH: No Eastern Carolina Pediatrics PC 1530 Mclure Ct Young, Dierdre MD Florence, SC 29505 Hill, Karen MD Provider ID: 1874604 (843) 667-6710 Provider ID: 769016 Gender: Female Fax: (843) 667-6791 Gender: Male Jeter Skinner Family Practice Mon - Fri 8:30 to 5:00 Pediatric Associates Of Florence 101 S Ravenel St, Ste 160 PCMH: No 204 E Cheves St Florence, SC 29506-2622 Florence, SC 29506 (843) 662-1533 (843) 777-5065 Fax: (843) 679-7273 Elder, Benjamin MD Fax: (843) 777-7620 Mon - Fri 8:00 to 5:00 Provider ID: 1238815 Mon - Fri 9:00 to 5:00 PCMH: No Gender: Male PCMH: No Pediatric Associates Of Florence 3013 W Palmetto St, Ste A Pediatrics Florence, SC 29501 Jordan, Meghan MD Bardi, Christopher MD (843) 777-9340 Provider ID: 2008990 Provider ID: 817970 Fax: (843) 777-7620 Gender: Female Gender: Male Mon - Fri 8:00 to 5:30 Pediatric Associates Of Florence Eastern Eastern Carolina Pediatric PCMH: No 204 E Cheves St, Ste 200 1530 Mclure Ct Florence, SC 29506-2604 Florence, SC 29505-5617 (843) 777-5065 Elder, Benjamin MD Fax: (843) 777-7620 (843) 667-6710 Provider ID: 1238816 Fax: (843) 667-6791 Mon - Fri 8:00 to 5:00 Gender: Male PCMH: No Mon - Fri 8:30 to 5:00 Pediatric Associates Of Florence PCMH: No 204 E Cheves St Florence, SC 29506 Jordan, Meghan MD Collins, Charles MD (843) 777-5065 Provider ID: 2008992 Provider ID: 768918 Fax: (843) 777-7620 Gender: Female Gender: Male Mon - Fri 8:00 to 5:30 Pediatric Associates Of Florence Pediatric Associates Of Florence Sat 9:00 to 9:00 3013b W Palmetto St 204 E Cheves St PCMH: No Florence, SC 29501-5935 Florence, SC 29506 (843) 777-5065 (843) 777-5065 Fax: (843) 777-7630 Fax: (843) 777-7620 Mon - Fri 8:00 to 5:00 Mcleod Regional Medical Center PCMH: No Mon - Fri 8:30 to 5:30 Sat 8:30 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 11 38642781

Primary Care Providers Florence Pediatrics - cont. Naylor, Brian MD Provider ID: 769775 Jordan, Meghan MD Gender: Male Provider ID: 2160864 Pediatric Associates Of Florence Gender: Female 3013 W Palmetto St, Ste B Pediatric Associates Of Florence Florence, SC 29501-5935 3013a W Palmetto St (843) 777-7604 Florence, SC 29501-5935 Mon - Fri 9:00 to 5:00 (843) 777-7604 PCMH: No Fax: (843) 777-7603 PCMH: No Spence, Thomas MD Provider ID: 767048 Keith, John MD Gender: Male Provider ID: 767025 Pediatric Associates Of Florence Gender: Male 204 E Cheves St Eastern Carolina Pediatrics PC Florence, SC 29506 1530 Mclure Ct (843) 777-5065 Florence, SC 29505 Fax: (843) 777-7620 (843) 667-6710 Mcleod Regional Medical Center Fax: (843) 667-6791 Mon - Fri 9:00 to 5:00 Mon - Fri 8:30 to 5:00 PCMH: No PCMH: No Spence, Timothy MD Minter, Ellen Patrice MD Provider ID: 768390 Provider ID: 767471 Gender: Male Gender: Female Pediatric Associates Of Florence Pediatric Associates Of Florence 204 E Cheves St 204 E Cheves St Florence, SC 29506 Florence, SC 29506 (843) 777-5065 (843) 777-5065 Fax: (843) 777-7620 Fax: (843) 777-7620 Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No Sat 9:00 to 12:00 PCMH: No Whitehead, Alva MD Provider ID: 768862 Naylor, Brian MD Gender: Male Provider ID: 769774 555 E Cheves St Gender: Male Florence, SC 29506-2617 Pediatric Associates Of Florence (843) 777-2000 204 E Cheves St PCMH: No Florence, SC 29506 (843) 777-5065 Fax: (843) 777-7620 Whitehead, Alva MD Mon - Fri 8:30 to 5:30 Provider ID: 768862 Sat 9:00 to 12:00 Gender: Male PCMH: No Pediatric Associates Of Florence 3013 W Palmetto St, Ste A Florence, SC 29501-5935 (843) 777-7603 Fax: (843) 777-7630 Mon - Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 12 38642781

Primary Care Providers Horry Family Practice Borst, Christopher MD Coates Gal, Chrystal MD Provider ID: 1206652 Provider ID: 2167019 Banks, Jerry MD Gender: Male Gender: Female Provider ID: 1265703 Doctors Care Strand Family First Health Clinic Pa Gender: Male 1221 21st Ave N 4612 Oleander Dr, Ste 102 Coastal Carolina Primary Care LLC Myrtle Beach, SC 29577-7401 Myrtle Beach, SC 29577-5711 839 82nd Pkwy (843) 626-9379 (843) 945-8117 Myrtle Beach, SC 29572 Fax: (843) 448-0707 Fax: (843) 945-8124 (843) 236-1950 Mon - Sun 8:00 to 8:00 Mon - Thu 8:30 to 4:00 Fax: (843) 236-1952 PCMH: No Fri 8:30 to 1:00 Mon - Thu 8:30 to 5:00 PCMH: No Fri 8:30 to 4:00 PCMH: No Brown, Alexis MD Provider ID: 1247392 Cress, Lyndsi DO Gender: Female Provider ID: 2132399 Beeraka, Prakash MD Georgetown Physician Associates Gender: Female Provider ID: 2370468 LLC Southern Medical Associates Gender: Male 4301 Dick Pond Rd 3418 Casey St Mcleod Internal Medicine Seacoast Myrtle Beach, SC 29588-6807 Loris, SC 29569-2904 3980 Highway 9 E, Ste 100b (843) 652-8100 (843) 756-7885 Little River, SC 29566-8163 Fax: (843) 652-8122 Fax: (843) 756-7855 (843) 390-5217 Mon - Thu 7:30 to 6:00 Mon - Thu 8:00 to 8:00 Fax: (843) 390-5257 Fri 8:00 to 5:00 Fri 8:00 to 2:00 Mon - Fri 8:30 to 5:00 PCMH: No PCMH: No PCMH: No Chee, Julie MD Eaton, Richard MD Boggs, Chris MD Provider ID: 2022730 Provider ID: 1206719 Provider ID: 1163413 Gender: Female Gender: Male Gender: Male Coastal Carolina Primary Care LLC Doctors Care Carolina Forest Waterway Family Medicine 839 82nd Parkway, Ste 185 200 Middleburg Dr 3600 Sea Mountain Hwy, Ste C Myrtle Beach, SC 29572-4614 Myrtle Beach, SC 29579-3408 Little River, SC 29566-8161 (843) 848-4640 (843) 903-6650 (843) 399-4848 Fax: (843) 839-2382 Fax: (843) 903-0758 Fax: (843) 399-4409 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 8:00 Mon - Fri 9:00 to 5:00 PCMH: No Sat 9:00 to 5:00 PCMH: No Sun 9:00 to 6:00 PCMH: No Christensen, Tom MD Boggs, Chris MD Provider ID: 1646836 Provider ID: 1343324 Gender: Male Epperson, William MD Gender: Male Sc House Calls Inc Provider ID: 1472133 Waterway Primary Care LLC 3600 Sea Mountain Hwy, Ste C Gender: Male 4237 River Hills Dr, Ste 150 Little River, SC 29566 Roper St. Francis Physician Partner Little River, SC 29566 (843) 399-4848 912 Inlet Square Dr, Ste B (843) 281-2778 Fax: (910) 653-2346 Murrells Inlet, SC 29576-7812 Fax: (843) 281-2785 Mon - Fri 8:00 to 5:00 (843) 651-4111 Mon, Wed - Thu 8:00 to 5:00 PCMH: No Fax: (843) 651-1047 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 13 38642781

Primary Care Providers Horry Family Practice - cont. Gibbs, Sean MD Gusic, Brittany MD Provider ID: 2022876 Provider ID: 2348566 Epperson, William MD Gender: Male Gender: Female Provider ID: 1766821 Coastal Carolina Primary Care LLC Cmc Primary Care Towne Center Gender: Male 839 82nd Parkway 5010 Carolina Forest Blvd Georgetown Physician Associates Ll Myrtle Beach, SC 29572 Myrtle Beach, SC 29579-3579 11916 Highway 707, Ste D (843) 236-1950 (843) 236-2700 Murrells Inlt, SC 29576-9610 Fax: (843) 236-1952 Fax: (843) 236-2726 (843) 652-8450 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 652-8451 PCMH: No PCMH: No Mon - Fri 8:30 to 5:00 PCMH: No Gluzberg, Tatyana MD Harmon, Gerald MD Provider ID: 1190796 Provider ID: 1484939 Floyd, James MD Roper St. Francis Physician Partner Gender: Male Provider ID: 1311537 4959 Highway 17 Georgetown Physician Associates Ll Gender: Male Murrells Inlet, SC 29576-5041 11891 Plaza Dr Sc House Calls Inc (843) 357-1299 Murrells Inlet, SC 29576 1400 Main St Fax: (843) 357-2264 (843) 353-0288 Conway, SC 29526 Mon - Fri 9:00 to 5:00 Fax: (843) 357-9770 (843) 488-0101 PCMH: No Mon - Fri 8:00 to 5:00 Fax: (843) 331-3979 PCMH: No Conway Medical Center Mon - Fri 8:30 to 5:00 Gluzberg, Tatyana MD PCMH: No Provider ID: 1190799 Harmon, Gerald MD Roper St. Francis After Hours Care- Provider ID: 1484940 912 Inlet Square Dr, Ste A Gender: Male Gammon, William MD Murrells Inlet, SC 29576-7812 Tidelands Health Family Medicine Provider ID: 2137103 (843) 357-1299 4320 Holmestown Rd Gender: Male Fax: (843) 651-1047 Myrtle Beach, SC 29588 Mcleod Family Medicine Carolina Mon - Fri 9:00 to 5:00 (843) 652-1293 For PCMH: No Fax: (843) 652-8132 101 Mcleod Health Blvd, Ste 201 Mon - Fri 8:00 to 5:00 Myrtle Beach, SC 29579-4477 PCMH: No (843) 646-8001 Gluzberg, Tatyana MD Fax: (843) 646-8002 Provider ID: 2022887 Mon - Fri 8:00 to 5:00 Gender: Female Harrah, Jason MD PCMH: No Coastal Carolina Primary Care LLC Provider ID: 1033610 4959 Hwy 17 Bypass South Gender: Male Murrells Inlet, SC 29576 Mcleod Family Medicine Carolina Gelb, Ernest DO (843) 357-1299 For Provider ID: 1724170 Fax: (843) 357-2264 101 Mcleod Health Blvd, Ste 201 Gender: Female Mon - Fri 8:00 to 5:00 Myrtle Beach, SC 29579-4477 Georgetown Physician Associates Ll PCMH: No (843) 646-8001 4320 Holmestown Rd Fax: (843) 646-8014 Myrtle Beach, SC 29588-7837 Mon - Fri 8:00 to 5:00 (843) 652-8440 Grubb, Stephen MD PCMH: No Fax: (843) 652-8441 Provider ID: 1733858 Mon - Fri 9:00 to 5:00 Gender: Male PCMH: No Sc House Calls Inc 3600 Sea Mountain Hwy, Suite C Little River, SC 29566 (843) 399-4848 Fax: (843) 399-4409 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 14 38642781

Primary Care Providers Horry Family Practice - cont. Karl, John MD Meixel, Steven MD Provider ID: 2136527 Provider ID: 1484941 Hess, Lori MD Gender: Male Gender: Male Provider ID: 1555449 Mcleod Family Medicine Carolina Tidelands Health Family Medicine Gender: Female For 4320 Holmestown Rd Georgetown Physician Associates 101 Mcleod Health Blvd, Ste 201 Myrtle Beach, SC 29588 LLC Myrtle Beach, SC 29579-4477 (843) 652-8440 11916 Highway 707, Ste D (843) 646-8001 Fax: (843) 652-8441 Murrells Inlet, SC 29576-9610 Fax: (843) 646-8002 Mon - Thu 8:30 to 6:00 (843) 652-8450 Mon - Fri 8:00 to 5:00 Fri 8:30 to 5:00 Fax: (843) 652-8451 PCMH: No PCMH: No Mon - Fri 8:30 to 5:00 PCMH: No Lindaberry, Jeffrey DO Mills, Timothy MD Provider ID: 2197069 Provider ID: 769787 Holt, Raymond MD Gender: Male Gender: Male Provider ID: 768433 Mcleod Dr. Lindaberry At Carolina F Family Health Center Loris Gender: Male 108 Finnegan Ct 3418 Casey St Seacoast Primary Care Myrtle Beach, SC 29579-4205 Loris, SC 29569-2904 3980 Highway 9 E, Ste 100 (843) 903-9993 (843) 756-7885 Little River, SC 29566-7873 Fax: (843) 903-3356 Fax: (843) 756-7855 (843) 390-8320 Mon - Tue, Thu - Fri 7:30 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 390-8329 Wed 7:30 to 2:30 PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No PCMH: No Molter, Darron MD Locklear-Batton, Ashley DO Provider ID: 1420288 Jain, Vasudha MD Provider ID: 1236467 Gender: Male Provider ID: 2268668 Gender: Female Mcleod Family Medicine Seacoast Gender: Female Mcleod Family Medicine Carolina 3980 Highway 9 E, Ste 100a Tidelands Health Family Medicine For Little River, SC 29566-8163 4320 Holmestown Rd 101 Mcleod Health Blvd, Ste 201 (843) 390-8320 Myrtle Beach, SC 29588-7837 Myrtle Beach, SC 29579 Fax: (843) 390-8329 (843) 652-8440 (843) 646-8001 Mon - Fri 8:00 to 5:00 Fax: (843) 652-8441 Fax: (843) 646-8002 PCMH: No Mon - Fri 8:00 to 5:00 Mon - Thu 8:00 to 5:00 PCMH: No Fri 8:00 to 12:00 PCMH: No Morando, Donald DO Provider ID: 2038872 Joslin, Richard MD Gender: Male Provider ID: 1206775 Malone, Michael MD Cpg Family Medicine At Bell Street Gender: Male Provider ID: 1562686 903 Bell St Doctors Care Little River Gender: Male Conway, SC 29526-4113 2246 Highway 17 Georgetown Physician Associates (843) 488-2111 Little River, SC 29566-9235 LLC Fax: (843) 488-2112 (843) 663-2220 4320 Holmestown Rd Mon - Fri 8:00 to 5:00 Fax: (843) 663-2221 Myrtle Beach, SC 29588-7837 PCMH: No Mon - Fri 8:00 to 8:00 (843) 652-8440 Sat - Sun 9:00 to 5:00 Fax: (843) 652-8441 PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 15 38642781

Primary Care Providers Horry Family Practice - cont. Nirenstein, Michael MD Rice, Nicole DO Provider ID: 1206832 Provider ID: 2368026 Morando, Donald DO Gender: Male Gender: Female Provider ID: 2297814 Doctors Care N. Myrtle Beach Mcleod Primary Care Seacoast Gender: Male 1714 Highway 17 S 3980 Highway 9 E, Ste 100 Cmc Primary Care Myrtle Trace North Myrtle Beach, SC 29582-4041 Little River, SC 29566-8163 8004 Myrtle Trace Drive (843) 361-0705 (843) 390-8320 Conway, SC 29526-4113 Fax: (843) 361-4045 Fax: (843) 390-8329 (843) 234-8939 Mon - Fri 8:00 to 8:00 Mon - Thu 8:00 to 5:00 Fax: (843) 234-8959 Sat - Sun 9:00 to 5:00 Fri 8:00 to 12:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No Papotto, Joseph DO Ross, Scott MD Muntean, Dan MD Provider ID: 926980 Provider ID: 2206749 Provider ID: 2383200 Gender: Male Gender: Male Gender: Male Life In A Blender LLC Cmc Primary Care Towne Center Cpg Primary Care At Sufside Beach 132 Pro Park Dr, Unit A 5010 Carolina Forest Blvd 1413 Highway 17 N Conway, SC 29526-9288 Myrtle Beach, SC 29579-3579 Surfside Beach, SC 29575 (843) 347-4900 (843) 236-2700 (843) 238-5654 Fax: (843) 347-4901 Fax: (844) 323-6272 Fax: (843) 238-1624 Mon - Tue, Thu 7:30 to 5:00 Mon - Thu 8:00 to 7:00 Mon - Fri 8:00 to 5:00 Wed 7:30 to 12:00 Fri 8:00 to 5:00 Sat 8:00 to 1:00 Fri 7:30 to 3:00 PCMH: No PCMH: No PCMH: No Rozario, Catherine MD Murphy, David MD Pelstring, Mark MD Provider ID: 1273469 Provider ID: 2207379 Provider ID: 767692 Gender: Female Gender: Male Gender: Male Jd Wellness And Urgent Care Cmc Primary Care Socastee Southern Medical Associates 287 Highway 90 E, Unit 6 6010 Highway 707, Ste 100 3418 Casey St Little River, SC 29566 Myrtle Beach, SC 29588 Loris, SC 29569-2904 (843) 741-0212 (843) 293-1005 (843) 756-7885 Fax: (843) 741-0213 Fax: (843) 293-1006 Fax: (843) 756-7855 Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 Mon - Fri 9:00 to 5:00 PCMH: No PCMH: No PCMH: No Ryan, Patrick DO Nguyen, Sean MD Prenatt, William MD Provider ID: 1298159 Provider ID: 2289038 Provider ID: 2318648 Gender: Male Gender: Male Gender: Male Sc House Calls Inc Georgetown Physician Associates Cmc Primary Care Towne Center 4600 Oleander Dr, Ste 2b LLC 5010 Carolina Forest Blvd Myrtle Beach, SC 29577 2200 Crow Ln, Ste 301 Myrtle Beach, SC 29579 (843) 448-2228 Myrtle Beach, SC 29577-1663 (843) 236-2700 Fax: (843) 448-2691 (843) 965-2822 Fax: (843) 236-2726 Mon - Fri 8:30 to 5:00 Fax: (843) 848-5305 Mon - Fri 8:00 to 5:00 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 16 38642781

Primary Care Providers Horry Family Practice - cont. Shadiack, Anthony DO Vandergriff, Joseph MD Provider ID: 2250102 Provider ID: 2016670 Sanders, Melanie MD Gender: Male Gender: Male Provider ID: 1759135 Grand Strand Primary Care Gme Surfside Beach Urgent Care LLC Gender: Female Inter 1945 Glenns Bay Rd Georgetown Physician Associates Ll 920 Doug White Dr, Ste 250 Surfside Beach, SC 29575-4833 4320 Holmestown Rd Myrtle Beach, SC 29572-4120 (843) 650-4006 Myrtle Beach, SC 29588-7837 (843) 236-1950 Fax: (843) 650-4225 (843) 652-8440 Fax: (843) 236-1952 Mon - Fri 8:00 to 8:00 Fax: (843) 652-8441 Mon - Fri 8:00 to 5:00 Sat - Sun 8:00 to 6:00 Mon - Wed, Fri 9:00 to 5:00 PCMH: No PCMH: No Thu 9:00 to 4:00 PCMH: No Stanley, Christopher MD Vandergriff, Joseph MD Provider ID: 1261415 Provider ID: 2267165 Schaefer, Catherine MD Gender: Male Gender: Male Provider ID: 2318654 907 Startek Dr Carolina Forest Urgent Care LLC Gender: Female Myrtle Beach, SC 29579-4471 185 Fresh Dr, Ste A Cmc Primary Care Socastee (843) 646-8001 Myrtle Beach, SC 29579 6010 Hwy 707, Ste 100 Fax: (843) 646-8002 (843) 945-3030 Myrtle Beach, SC 29588 PCMH: No Fax: (843) 492-7749 (843) 293-1005 Mon - Fri 8:00 to 6:00 Fax: (843) 293-1006 PCMH: No Mon - Fri 8:00 to 5:00 Stanley, Christopher MD PCMH: No Provider ID: 1261415 Gender: Male Vandergriff, Joseph MD Mcleod Family Medicine Carolina Provider ID: 907382 Schimnowski, Amanda MD For Gender: Male Provider ID: 2318656 101 Mcleod Health Blvd, Ste 201 South Strand Internists Pa Gender: Female Myrtle Beach, SC 29579-4477 1945 Glenns Bay Rd Cmc Primary Care Socastee (843) 646-8001 Surfside Beach, SC 29575-4833 6010 Hwy 707, Ste 100 Fax: (843) 646-8002 (843) 650-4006 Myrtle Beach, SC 29588 Mon - Fri 8:00 to 5:00 Fax: (843) 650-1418 (843) 293-1005 PCMH: No Mon - Fri 7:30 to 5:00 Fax: (843) 293-1006 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Vandergriff, Joseph MD Provider ID: 2016669 Vest, James MD Gender: Male Provider ID: 2383453 Shadiack, Anthony DO Carolina Forest Urgent Care LLC Gender: Male Provider ID: 2249979 185 Fresh Dr, Ste A Cmc Primary Care Postal Way Gender: Male Myrtle Beach, SC 29579-4436 4022 Postal Way Grand Strand Primary Care Gme (843) 945-3030 Myrtle Beach, SC 29579-3537 Famil Mon - Fri 8:00 to 8:00 (843) 236-0000 839 82nd Parkway, Ste 185 Sat - Sun 8:00 to 6:00 Fax: (843) 236-6191 Myrtle Beach, SC 29572-4614 PCMH: No Mon - Fri 8:00 to 5:00 (843) 848-4640 Sat 8:00 to 12:00 Fax: (843) 839-2382 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 17 38642781

Primary Care Providers Horry Family Practice - cont. Wilkoszewski, Artur MD Federally Qualified Health Center Provider ID: 1206887 Vest, James MD Gender: Male Careteam Plus Inc Provider ID: 2383460 Doctors Care Conway 501 Provider ID: 2118031 Gender: Male 1113 Church St Careteam Plus Cmc Primary Care Surfside Conway, SC 29526-4128 100 Professional Park Dr 1413 Highway 17 N (843) 248-6269 Conway, SC 29526-9260 Surfside Beach, SC 29575 Fax: (843) 248-0535 (843) 234-8005 (843) 238-5654 Mon - Sun 8:00 to 8:00 Mon - Thu 8:00 to 5:00 Fax: (843) 238-1624 PCMH: No Fri 8:00 to 1:00 Mon - Fri 8:00 to 5:00 PCMH: No Sat 8:00 to 12:00 PCMH: No Williams, Tisha MD Provider ID: 1186610 Little River Medical Center Gender: Female Provider ID: 2197457 Vinson, Tiffany MD Georgetown Physician Associates Ll Little River Medical Center Inc Provider ID: 1780372 4040 Highway 17, Ste 104 4200 Carolina Exchange Dr Gender: Female Murrells Inlet, SC 29576-5098 Myrtle Beach, SC 29579-4220 Doctors Care Surfside (843) 652-8150 (843) 663-8000 1600 Highway 17 N Fax: (843) 652-8151 Fax: (843) 663-8123 Surfside Bch, SC 29575-6015 Mon - Fri 8:30 to 5:00 Mon - Fri 8:00 to 7:00 (843) 238-1461 PCMH: No PCMH: No Fax: (843) 828-0622 Mon - Sun 8:00 to 8:00 PCMH: No Wright, Lisa MD Little River Medical Center Provider ID: 2025917 Provider ID: 2197490 Gender: Female Little River Medical Center Inc Watson, Heber DO Coastal Carolina Primary Care LLC 1005 Osceola St Provider ID: 2339497 4959 Hwy 17 Bypass South Myrtle Beach, SC 29577-8008 Gender: Male Murrells Inlet, SC 29576 (843) 663-8000 Cmc Primary Care Myrtle Trace (843) 357-1299 Fax: (843) 663-8123 8004 Myrtle Trace Dr Fax: (843) 357-2264 Mon 13:00 to 17:30 Conway, SC 29526-8945 Mon - Fri 8:00 to 5:00 Thu 8:30 to 12:00 (843) 234-8939 PCMH: No PCMH: No Fax: (843) 234-8959 Mon - Fri 8:00 to 5:00 General Practice PCMH: No Xiong, Chue MD Provider ID: 2318512 Mayeaux II, Eugene MD Gender: Male Provider ID: 1714276 Whitley, Allie DO Mcleod Primary Care Seacoast Provider ID: 2304702 Gender: Male 3980 Highway 9 E, Ste 100 Georgetown Physician Associates Ll Gender: Female Little River, SC 29566-8163 Mcleod Primary Care Seacoast 4320 Holmestown Rd (843) 390-8320 Myrtle Beach, SC 29588-7837 3980 Highway 9 E, Ste 100 Fax: (843) 390-8329 Little River, SC 29566-8163 (843) 652-8440 Mon - Fri 8:00 to 5:00 Fax: (843) 652-8441 (843) 390-8320 PCMH: No Fax: (843) 390-8329 Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 18 38642781

Primary Care Providers Horry General Practice - cont. Adler, Brian MD Barrett, Gary MD Provider ID: 2267168 Provider ID: 768538 Rives, Thomas MD Gender: Male Gender: Male Provider ID: 2318595 South Strand Internists Pa Barrett Internal Medicine Gender: Male 1945 Glenns Bay Rd, Ste A 3109 Casey St, Ste B Mcleod Primary Care Little River Surfside Beach, SC 29575 Loris, SC 29569-2807 4237 River Hills Dr, Ste 170 (843) 650-4006 (843) 756-9292 Little River, SC 29566-6446 Fax: (843) 650-1418 Fax: (843) 756-9260 (843) 366-3030 Mon - Fri 7:30 to 5:00 Mon - Fri 9:00 to 5:00 Fax: (843) 663-0537 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Adler, Brian MD Benson, Paul MD Provider ID: 769251 Provider ID: 1555607 Turek, James MD Gender: Male Gender: Male Provider ID: 960855 South Strand Internists Georgetown Physician Associates Ll Gender: Male 1945 Glenns Bay Rd 4040 Hwy 17 Bypass, Ste 302 Tideland Health Family Medicine Myrtle Beach, SC 29575 Murrells Inlet, SC 29576 2347 S Highway 17 (843) 650-4006 (843) 652-8290 Garden City, SC 29576 Fax: (843) 650-1418 Fax: (843) 652-8299 (843) 357-2443 Mon - Fri 8:00 to 5:00 Mon - Fri 8:30 to 5:00 Fax: (843) 357-2132 PCMH: No PCMH: No Mon - Fri 8:00 to 6:00 Sat 9:00 to 1:00 PCMH: No Allen, Sarah MD Brazee, Jacob DO Provider ID: 1484942 Provider ID: 1539264 Gender: Female Gender: Male Internal Medicine Tidelands Health Family Medicine Georgetown Physician Associates Ll Adamson, James MD 4320 Holmestown Rd 4301 Dick Pond Rd Provider ID: 1653315 Myrtle Beach, SC 29588 Myrtle Beach, SC 29588-6807 Gender: Male (843) 652-8440 (843) 652-8100 Careteam Plus Inc. Fax: (843) 652-8132 Fax: (843) 652-8122 100 Professional Park Dr Mon - Thu 7:30 to 6:00 Mon - Thu 7:30 to 6:00 Conway, SC 29526-9260 Fri 8:00 to 5:00 Fri 8:00 to 5:00 (843) 234-0005 PCMH: No PCMH: No Fax: (843) 234-8234 Mon - Fri 8:00 to 12:00 Atienza, Jonessa Ann MD Collier, Victor MD PCMH: No Provider ID: 1433906 Provider ID: 1254813 Gender: Female Gender: Male Adler, Brian MD Mcleod Internal Medicine Seacoast Coastal Carolina Primary Care LLC Provider ID: 2005666 3980 Highway 9 E, Ste 100b 839 82nd Pkwy Gender: Male Little River, SC 29566-8163 Myrtle Beach, SC 29572 Liberty Doctors LLC D/B/A South (843) 390-5217 (843) 236-1950 Str Fax: (843) 390-5257 Fax: (843) 236-1952 1945 Glenns Bay Rd Mon - Fri 8:00 to 5:00 Mon - Thu 8:30 to 5:00 Surfside Bch, SC 29575-4833 PCMH: No Fri 8:30 to 4:00 (843) 650-4006 PCMH: No Fax: (843) 650-1418 Mon - Fri 7:30 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 19 38642781

Primary Care Providers Horry Internal Medicine - cont. Griesmer, Brendan MD Nambudiri, Vinod MD Provider ID: 1784084 Provider ID: 1431349 Comianos, Marc DO Gender: Male Gender: Male Provider ID: 1639571 Mcleod Family Medicine Carolina Coastal Carolina Primary Care LLC Gender: Male For 8170 Rourk St, Ste 100 Southern Medical Associates 101 Mcleod Health Blvd, Ste 201 Myrtle Beach, SC 29572 3418 Casey St Myrtle Beach, SC 29579-4477 (843) 497-7772 Loris, SC 29569-2904 (843) 646-8001 Fax: (843) 236-7952 (843) 756-7885 Fax: (843) 646-8002 Mon - Thu 8:30 to 4:30 Fax: (843) 756-7855 Mon - Fri 8:00 to 5:00 Fri 8:30 to 4:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No Johnson, David MD Pandoo, Justin MD Courtney, Donald MD Provider ID: 1561550 Provider ID: 1731255 Provider ID: 2222503 Gender: Male Gender: Male Gender: Male Mcleod ENT Seacoast Cpg Carolina Internal Medicine Coastal Carolina Primary Care LLC 3980 Highway 9 E, Ste 100b 2367b Cypress Cir 920 Doug White Dr, Ste 250 Little River, SC 29566-8165 Conway, SC 29526-8921 Myrtle Beach, SC 29572-4181 (843) 390-5217 (843) 349-1001 (843) 236-1950 Fax: (843) 390-8329 Fax: (843) 349-1008 Fax: (843) 236-1952 Mon - Fri 9:00 to 5:00 Mon - Thu 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No Fri 8:00 to 1:00 PCMH: No PCMH: No Mangano, Andrew DO Gal, Almog MD Provider ID: 1420820 Remines, Michael DO Provider ID: 2166977 Gender: Male Provider ID: 2339744 Gender: Male Grand Strand Primary Care Gme - Gender: Male Family First Health Clinic Pa Int Cmc Primary Care Postal Way 4612 Oleander Dr, Ste 102 8170 Rourk St, Ste 100 4022 Postal Way Myrtle Beach, SC 29577-5711 Myrtle Beach, SC 29572-4127 Myrtle Beach, SC 29579-3537 (843) 945-8117 (843) 236-1950 (843) 236-0000 Fax: (843) 945-8124 Fax: (843) 236-1952 Fax: (843) 236-6191 Mon - Thu 8:30 to 4:00 Mon - Fri 8:30 to 5:00 Mon - Fri 8:00 to 5:00 Fri 8:00 to 1:00 PCMH: No Sat 8:00 to 12:00 PCMH: No PCMH: No Morjain, Jessica DO Gobin, Mark DO Provider ID: 1600871 Sansbury, Jilian MD Provider ID: 2022889 Gender: Female Provider ID: 2249920 Gender: Male Georgetown Physician Associates Gender: Female Coastal Carolina Primary Care LLC LLC Grand Strand Primary Care Gme 8170 Rourk St, Ste 100 2347 S Highway 17 Inter Myrtle Beach, SC 29572-4127 Murrells Inlet, SC 29576-7611 8170 Rourk St, Ste 100 (843) 236-1950 (843) 357-2443 Myrtle Beach, SC 29572-4127 Fax: (843) 236-1952 Fax: (843) 357-2132 (843) 236-1950 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:30 Fax: (843) 236-1952 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 20 38642781

Primary Care Providers Horry Internal Medicine - cont. Varney, Michael MD Obstetrics/Gynecology Provider ID: 1206881 Sansbury, Jilian MD Gender: Male Collins, Nancy MD Provider ID: 2249946 Doctors Care Little River Provider ID: 910050 Gender: Female 2246 Highway 17 Gender: Female Grand Strand Primary Care Im Little River, SC 29566-9235 8016 Myrtle Trace Dr 920 Doug White Dr, Ste 250 (843) 663-2220 Conway, SC 29526-8945 Myrtle Beach, SC 29572-4181 Fax: (843) 663-2221 (843) 347-7266 (843) 236-1950 Mon - Fri 8:00 to 8:00 Fax: (843) 347-2130 Fax: (843) 236-1952 Sat - Sun 9:00 to 5:00 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Collins, Nancy MD Nurse Practitioner Provider ID: 910050 Silbiger, Stephen MD Gender: Female Provider ID: 1991543 Anderson, Alicia NP Cmc Women's Health Conway Gender: Male Provider ID: 2267166 2376 Cypress Cir, Ste 200 Grand Strand Surgical Specialists L Gender: Female Conway, SC 29526-8945 809 82nd Pkwy Carolina Forest Urgent Care LLC (843) 347-7216 Myrtle Beach, SC 29572-4607 185 Fresh Dr, Ste A Fax: (843) 347-7218 (843) 497-6348 Myrtle Beach, SC 29579 PCMH: No Fax: (843) 497-6351 (843) 945-3030 Mon - Fri 8:00 to 5:00 Fax: (843) 492-7749 PCMH: No Mon - Fri 8:00 to 6:00 Collins, Nancy MD PCMH: No Provider ID: 910050 Gender: Female Sperling, Michael MD Cpg Womens Medicla Center Provider ID: 2251617 Dorr, Rachel NP 8004 Myrtle Trace Dr Gender: Male Provider ID: 2267164 Conway, SC 29526-8945 Mcleod Internal Medicine Seacoast Gender: Female (843) 347-7216 3980 Highway 9 E, Ste 100b Carolina Forest Urgent Care LLC Fax: (843) 347-7218 Little River, SC 29566-8163 185 Fresh Dr, Ste A Mon - Thu 8:30 to 5:00 (843) 390-5217 Myrtle Beach, SC 29579 Fri 8:30 to 12:30 Fax: (843) 390-5257 (843) 945-3030 PCMH: No Mon - Fri 8:00 to 5:00 Fax: (843) 492-7749 PCMH: No Mon - Fri 8:00 to 6:00 PCMH: No Levenson, Terry MD Provider ID: 911709 Trinh, Vinh DO Gender: Male Provider ID: 1566276 Smith, Tara NP 300 Singleton Ridge Rd Gender: Male Provider ID: 2267167 Conway, SC 29526-9142 Grand Strand Primary Care Gme - Gender: Female (843) 347-7111 Int South Strand Internists Pa PCMH: No 8170 Rourk St, Ste 100 1945 Glenns Bay Rd, Ste B Myrtle Beach, SC 29572-4127 Surfside Beach, SC 29575 (843) 497-6348 (843) 650-4006 Levenson, Terry MD Fax: (843) 497-6351 Fax: (843) 650-4225 Provider ID: 911709 Mon - Fri 8:30 to 5:00 Mon - Fri 7:30 to 5:00 Gender: Male PCMH: No PCMH: No Cmc Women's Health Conway 2376 Cypress Cir, Ste 200 Conway, SC 29526-8945 (843) 347-7216 Fax: (843) 347-7218 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 21 38642781

Primary Care Providers Horry Obstetrics/Gynecology - cont. Lukowski, Jessica MD Corontzes, Stephen MD Provider ID: 900408 Provider ID: 767908 Levenson, Terry MD Gender: Female Gender: Male Provider ID: 911709 Cpg Womens Medical Center Magnolia Pediatrics Gender: Male 8004 Myrtle Trace Dr 600 Singleton Ridge Rd Cpg Womens Medical Center Conway, SC 29526-8945 Conway, SC 29526 8004 Myrtle Trace Dr (843) 347-7216 (843) 347-9099 Conway, SC 29526-8945 Fax: (843) 347-7218 Fax: (888) 972-4460 (843) 347-7216 Mon - Thu 8:30 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 347-7218 Fri 8:30 to 12:30 Sat 8:00 to 12:00 Mon - Thu 8:30 to 5:00 PCMH: No PCMH: No Fri 8:30 to 12:30 PCMH: No Thompson, Kenneth DO Daniels, Frederick MD Provider ID: 812576 Provider ID: 1188741 Lineback, Bradley MD Gender: Male Gender: Male Provider ID: 979867 Cmc Women's Health Towne Seashore Pediatrics Gender: Male Center 170 Surfrider Blvd Cmc Women's Health Conway 5010 Carolina Forest Blvd Longs, SC 29568 2376 Cypress Cir, Ste 200 Myrtle Beach, SC 29579 (843) 390-2229 Conway, SC 29526-8945 (843) 903-1010 Fax: (843) 390-2483 (843) 347-7216 Fax: (843) 903-1015 Mon - Fri 8:00 to 5:00 Fax: (843) 347-7218 Conway Medical Center PCMH: No PCMH: No Mon - Thu 9:00 to 5:00 Fri 9:00 to 1:00 PCMH: No Eglen, Rebecca MD Lineback, Bradley MD Provider ID: 1994994 Provider ID: 979867 Gender: Female Gender: Male Pediatrics Cmc Pediatrics Socastee Cpg Conway Ob Gyn 6010 Highway 707, Ste 100 8016 Myrtle Trace Dr Borden, Danika MD Myrtle Beach, SC 29588-7321 Conway, SC 29526-8945 Provider ID: 2392379 (843) 293-1005 (843) 347-7266 Gender: Female Fax: (843) 293-1006 Fax: (843) 347-2130 Cmc Pediatrics Conway Conway Medical Center Mon - Wed 8:30 to 5:00 124 Professional Park Dr, Ste A Mon - Thu 8:00 to 7:00 Thu - Fri 8:30 to 12:30 Conway, SC 29526 Fri 8:30 to 7:00 PCMH: No (843) 234-8788 Sat 8:00 to 12:00 Fax: (843) 234-8787 PCMH: No Mon - Thu 8:00 to 5:00 Lukowski, Jessica MD Fri 8:00 to 12:00 Provider ID: 900408 PCMH: No Ludlow, Donald MD Gender: Female Provider ID: 417936 Cmc Women's Health Conway Gender: Male 2376 Cypress Cir, Ste 200 Caudle, Tory MD 3655 Mitchell St Conway, SC 29526-8945 Provider ID: 1173938 Loris, SC 29569-2827 (843) 347-7216 Gender: Female (843) 716-7000 Fax: (843) 347-7218 Seashore Pediatrics PCMH: No PCMH: No 2828 Bayboro St Loris, SC 29569 (843) 716-2229 Fax: (843) 716-2483 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 22 38642781

Primary Care Providers Horry Pediatrics - cont. Walker, Juliette MD Provider ID: 1959564 Ludlow, Donald MD Gender: Female Provider ID: 768111 Cpg Pediatrics At Carolina Forest Gender: Male 4022 Postal Way, Ste C Seashore Pediatrics Myrtle Beach, SC 29579-3537 170 Surfrider Blvd, Suite A B (843) 903-4111 Longs, SC 29568-9252 Fax: (843) 903-4242 (843) 390-2229 Mon - Fri 8:00 to 5:00 Fax: (843) 716-2483 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Walker, Juliette MD Provider ID: 2318659 Nichols, William MD Gender: Female Provider ID: 2318642 Cmc Prediatrics Conway Gender: Male 2376 Cypress Cir, Ste 103 Cmc Pediatrics Conway Conway, SC 29588 2376 Cypress Cir, Ste 103 (843) 234-8788 Conway, SC 29526 Fax: (843) 234-8787 (843) 234-8788 Mon - Fri 8:00 to 5:00 Fax: (843) 234-8787 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No

Nichols, William MD Provider ID: 914077 Gender: Male Cpg Pediatrics Carolina Forest 4022 Postal Way, Ste C Myrtle Beach, SC 29579-3537 (843) 903-4111 Fax: (843) 903-4242 Mon - Thu 8:30 to 5:00 Fri 8:30 to 12:00 PCMH: No

Rabon, Brian MD Provider ID: 1156517 Gender: Male Palmetto Pediatrics Of Conway Inc 140 Professional Park Dr Conway, SC 29526 (843) 234-5678 Fax: (843) 234-4567 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 23 38642781

Primary Care Providers Marion Family Practice Musc Health Primary Care Marion Musc Childrens Pee Dee Pediat- rics Marion Campbell, Treadwell MD Provider ID: 1850003 Provider ID: 981400 Provider ID: 1850017 1205 N Main St Musc Childrens Pee Dee Pediatrics Gender: Male Marion, SC 29571-2008 Campbell Family Practice Pa 2845 E Highway 76, Ste 5 (843) 423-0760 Mullins, SC 29574-6037 2835 E Highway 76, Ste 6 Fax: (843) 423-8138 Mullins, SC 29574-6038 (843) 431-2720 Mon - Fri 8:00 to 5:00 Fax: (843) 431-2647 (843) 431-9882 PCMH: No Fax: (843) 431-9879 Mon - Fri 8:00 to 5:00 Mon - Fri 8:30 to 5:00 PCMH: No PCMH: No Musc Health Primary Care Mullins Musc Health Primary Care Marion Provider ID: 1849974 Garner, James MD 511 S Main St Provider ID: 1850003 Provider ID: 767439 Mullins, SC 29574-3509 1205 N Main St Gender: Male (843) 464-8244 Marion, SC 29571-2008 Mcleod Family Medicine Of Marion Fax: (843) 464-6519 (843) 423-0760 3032 E Highway 76 Mon - Fri 8:00 to 5:00 Fax: (843) 423-8138 Mullins, SC 29574 PCMH: No Mon - Fri 8:00 to 5:00 (843) 464-7111 PCMH: No Fax: (843) 292-7324 Mon - Fri 9:00 to 5:00 Odom, John MD PCMH: No Provider ID: 766825 Musc Health Primary Care Mullins Gender: Male Mcleod Family Medicine Of Marion Provider ID: 1849974 Musc Childrens Pediatrics Marion 3032 E Highway 76 511 S Main St Medical Mullins, SC 29574 Mullins, SC 29574-3509 Provider ID: 1850063 (843) 777-7780 (843) 464-8244 Musc Childrens Pediatrics Marion Fax: (843) 292-7324 Fax: (843) 464-6519 Me Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 2845 E Highway 76, Ste 4 PCMH: No PCMH: No Mullins, SC 29574-6037 (843) 431-2720 Rural Health Center Fax: (843) 431-2726 Mon - Fri 8:00 to 5:00 Musc Childrens Pediatrics Marion PCMH: No Medical Provider ID: 1850063 Musc Childrens Pee Dee Pediat- Musc Childrens Pediatrics Marion rics Marion Me Provider ID: 1850017 2845 E Highway 76, Ste 4 Musc Childrens Pee Dee Pediatrics Mullins, SC 29574-6037 2845 E Highway 76, Ste 5 (843) 431-2720 Mullins, SC 29574-6037 Fax: (843) 431-2726 (843) 431-2720 Mon - Fri 8:00 to 5:00 Fax: (843) 431-2647 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 24 38642781

Primary Care Providers Marlboro Family Practice Duncan, Anna DO Provider ID: 1271010 Gender: Female Caresouth Carolina Inc Subspecialty: HRSA FQHC 999 Cheraw St Bennettsville, SC 29512 (843) 479-2341 Fax: (843) 479-2346 Mon - Fri 8:00 to 5:00 PCMH: No

Pediatrics Acaylar, Francis MD Provider ID: 767732 Gender: Male Mcleod Pediatrics And Primary Care 1076 Marlboro Way, Ste 3 Bennettsville, SC 29512-2495 (843) 479-0432 Fax: (843) 479-3036 Mon - Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 25 38642781

Primary Care Providers Williamsburg Family Practice Crosby, Thomas MD Provider ID: 1245653 Adkins, Henry MD Gender: Male Provider ID: 1244950 Georgetown Physician Associtaes Gender: Male LLC Georgetown Physician Associtaes 456 N Main St LLC Hemingway, SC 29554 456 N Main St (843) 558-9319 Hemingway, SC 29554 Fax: (843) 558-9818 (843) 558-9319 Mon - Fri 8:00 to 5:00 Fax: (843) 558-9818 Sat 8:30 to 12:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Ellis, Richard MD Allen, Raymond MD Provider ID: 767523 Provider ID: 769685 Gender: Male Gender: Male Musc Physicians Primary Care Mcleod Family Medicine Kingstree Kingst 512 Nelson Blvd, Ste 200 342 W Main St Kingstree, SC 29556 Kingstree, SC 29556-3235 (843) 355-5459 (843) 355-3621 Fax: (843) 355-9704 Fax: (843) 355-3624 Mon - Fri 7:30 to 6:00 Musc Health Florence Medical PCMH: No Center Mon - Fri 8:00 to 5:00 Atkinson, Ernest MD PCMH: No Provider ID: 767198 Gender: Male Mims, Albert MD Musc Physicians Primary Care Provider ID: 768631 Kingst Gender: Male 342 W Main St Musc Physicians Primary Care Kingstree, SC 29556 Kingst (843) 355-3621 342 W Main St Fax: (843) 355-3624 Kingstree, SC 29556-3235 Musc Health Florence Medical (321) 452-4470 Center Fax: (843) 355-3624 Mon, Wed - Fri 8:00 to 5:00 Musc Health Florence Medical Tue 2:00 to 10:00 Center PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Brown, Morris MD Provider ID: 1051420 Gender: Male Family Medicine Associates LLC 505 Thurgood Marshall Hwy Kingstree, SC 29556-4107 (843) 355-8380 Fax: (843) 355-5247 Lake City Community Hospital Mon - Wed 8:00 to 4:30 Thu - Fri 8:00 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 26 38642781

Specialty Physicians Chesterfield Family Practice Pack, Mark MD Neurology Provider ID: 1168395 Biester, Christina MD Gender: Male Almidani, Mazen MD Provider ID: 769529 Mcleod Surgery Cheraw Provider ID: 2318889 Gender: Male 721 S Doctors Dr Gender: Male Csc Chesterfield Cheraw, SC 29520-7108 Mcleod Health Cheraw Subspecialty: HRSA FQHC (843) 320-9086 711 Chesterfield Hwy 500 West Blvd Fax: (843) 320-1257 Cheraw, SC 29520-7002 Chesterfield, SC 29709-1402 Mon - Fri 8:00 to 5:00 (843) 777-5240 (843) 623-5080 PCMH: No Fax: (843) 777-5572 Fax: (843) 623-5081 Mon - Sun 12:00 to 12:00 Languages: Dutch PCMH: No Mon - Fri 8:30 to 5:00 Thomas, Chadwick MD PCMH: No Provider ID: 1700450 Gender: Male Corti, Sandro MD Mcleod Surgery Cheraw Provider ID: 2318922 General Surgery 721 S Doctors Dr Gender: Male Cheraw, SC 29520-7108 Mcleod Health Cheraw Dameron, Jason MD 711 Chesterfield Hwy Provider ID: 1847116 (843) 320-9086 Fax: (843) 320-1257 Cheraw, SC 29520-7002 Gender: Male (843) 777-5240 Mcleod Health Cheraw Mon - Fri 8:00 to 5:00 PCMH: No Fax: (843) 777-5572 721 S Doctors Dr Mon - Sun 12:00 to 12:00 Cheraw, SC 29520-7108 PCMH: No (843) 320-9086 Tolmos, Jorge MD Fax: (843) 320-1257 Provider ID: 1710842 Mon - Fri 8:00 to 5:00 Gender: Male Khishchenko, Natan MD PCMH: No Mcleod Surgery Cheraw Provider ID: 2318929 721 S Doctors Dr Gender: Male Cheraw, SC 29520-7108 Mcleod Health Cheraw Ghorra, Salim MD 711 Chesterfield Hwy Provider ID: 857921 (843) 320-9086 Fax: (843) 320-1257 Cheraw, SC 29520-7002 Gender: Male (843) 777-5240 Mcleod Surgery Cheraw Mon - Fri 8:00 to 5:00 PCMH: No Fax: (843) 777-5572 721 S Doctors Dr, # C Mon - Sun 12:00 to 12:00 Cheraw, SC 29520-7108 PCMH: No (843) 320-9086 Neuro Psychiatrist Md Fax: (843) 320-9087 Mon - Fri 8:00 to 5:00 Dimkpa, Rajeshree MD Li, Sui MD PCMH: No Provider ID: 1520151 Provider ID: 2318939 Gender: Female Gender: Male Integrated Care Services Inc Mcleod Health Cheraw Harling, Michael MD 110 Duvall St 711 Chesterfield Hwy Provider ID: 1584826 Cheraw, SC 29520-2406 Cheraw, SC 29520-7002 Gender: Male (843) 253-5076 (843) 777-5240 Mcleod Surgery Cheraw Fax: (843) 253-5100 Fax: (843) 777-5572 721 S Doctors Dr Mon - Fri 8:00 to 5:00 Mon - Sun 12:00 to 12:00 Cheraw, SC 29520-7108 PCMH: No PCMH: No (843) 320-9086 Fax: (843) 320-1257 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 27 38642781

Specialty Physicians Chesterfield Neurology - cont. Null, Elizabeth MD Kolb, Cynthia MD Provider ID: 2318968 Provider ID: 774288 Mehari, Tigist MD Gender: Female Gender: Female Provider ID: 2318943 Mcleod Health Cheraw Mcleod Ob/Gyn Cheraw Gender: Female 711 Chesterfield Hwy 721 Chesterfield Hwy Mcleod Health Cheraw Cheraw, SC 29520-7002 Cheraw, SC 29520-7002 711 Chesterfield Hwy (843) 777-5240 (843) 921-1211 Cheraw, SC 29520-7002 Fax: (843) 777-5572 Fax: (843) 921-1213 (843) 777-5240 Mon - Sun 12:00 to 12:00 Mon - Fri 9:00 to 5:00 Fax: (843) 777-5572 PCMH: No PCMH: No Mon - Sun 12:00 to 12:00 PCMH: No Patel, Neil MD Schindler, Joycelyn MD Provider ID: 2318971 Provider ID: 970568 Mendelson, Joshua MD Gender: Male Gender: Female Provider ID: 2318945 Mcleod Health Cheraw Mcleod OBGYN Cheraw Gender: Male 711 Chesterfield Hwy 721 Chesterfield Hwy Mcleod Health Cheraw Cheraw, SC 29520-7002 Cheraw, SC 29520-7002 711 Chesterfield Hwy (843) 777-5240 (843) 921-1211 Cheraw, SC 29520-7002 Fax: (843) 777-5572 Fax: (843) 921-1213 (843) 777-5240 Mon - Sun 12:00 to 12:00 Mcleod Loris Seacoast Ho Fax: (843) 777-5572 PCMH: No Languages: Tagalog Mon - Sun 12:00 to 12:00 Mon - Fri 9:00 to 5:00 PCMH: No Obstetrics/Gynecology PCMH: No Murtaza, Amir MD Hoffman, Michael MD Ophthalmology Provider ID: 2318960 Provider ID: 1162575 Gender: Male Gender: Male French, John MD Mcleod Health Cheraw Mcleod Ob Gyn Cheraw Provider ID: 960610 711 Chesterfield Hwy 721 Chesterfield Hwy Gender: Male Cheraw, SC 29520-7002 Cheraw, SC 29520-7002 John W Fench Md (843) 777-5240 (843) 537-7881 705 Chesterfield Hwy Fax: (843) 777-5572 Fax: (843) 921-1213 Cheraw, SC 29520-7002 Mon - Sun 12:00 to 12:00 Mon - Fri 8:00 to 5:00 (843) 537-7711 PCMH: No PCMH: No Fax: (843) 537-9582 Mon - Fri 8:00 to 5:00 Newman, Richard MD Kolb, Cynthia MD PCMH: No Provider ID: 2318967 Provider ID: 774288 Gender: Male Gender: Female Optometry Mcleod Health Cheraw Mcleod Ob/Gyn Bennettsville 711 Chesterfield Hwy 1076 Marlboro Way, Ste 1 Covington, Al OD Cheraw, SC 29520-7002 Cheraw, SC 29520-7002 Provider ID: TPVCOVI02-01 (843) 777-5240 (843) 454-2294 Gender: Male Fax: (843) 777-5572 Fax: (843) 454-1657 Covington Optometric Eye Clini Mon - Sun 12:00 to 12:00 Mon - Fri 9:00 to 5:00 703 Market Street PCMH: No PCMH: No Cheraw, SC 29520 (843) 537-3641 Fax: (843) 537-3646 www.covingtoneye.com Mon, Wed 9:00 to 5:00 Tue, Thu 9:00 to 9:00 Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 28 38642781

Specialty Physicians Chesterfield Optometry - cont. Mcdowell, James OD Provider ID: TPVMCDO17-01 Gender: Male Drs Kelley & Mcdowell Pa 217 North Pearl Street Pageland, SC 29728 (843) 672-7233 Fax: (843) 672-7234 Wed 8:30 to 12:00 PCMH: No

Psychiatry Ogunfowora, Ayodele MD Provider ID: 1708792 Gender: Male Sandhill Medical Foundation Jeffers 409 E Church St Jefferson, SC 29718 (843) 658-3055 Fax: (843) 658-7780 Mon - Fri 8:00 to 5:00 PCMH: No

Ogunfowora, Ayodele MD Provider ID: 1708792 Gender: Male Sandhill Medical Foundation Mcbee 645 S 7th St Mcbee, SC 29101 (843) 335-8291 Fax: (843) 335-8291 Mon - Fri 8:00 to 5:00 PCMH: No

Vascular Surgery Rzucidlo, Eva MD Provider ID: 1164665 Gender: Female 710 Chesterfield Hwy Cheraw, SC 29520-7001 (843) 777-7043 Fax: (843) 777-7041 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 29 38642781

Specialty Physicians Darlington Allergy & Immunology Guha, Prabal MD Skipper, Stephen DC Provider ID: 770147 Provider ID: 771663 Stone, Harry MD Gender: Male Gender: Male Provider ID: 777042 Mcleod Cardiology Associates Center For Health And Wellness PC Gender: Male 1319 S 4th St 600 W Carolina Ave Stone Jr Harry D Hartsville, SC 29550-7458 Hartsville, SC 29550-4410 701 Medical Park Dr, Ste 104 (843) 667-1891 (843) 383-2340 Hartsville, SC 29550 Fax: (843) 665-2516 Fax: (843) 383-2341 (843) 332-3191 Mon - Fri 9:00 to 5:00 Mon - Fri 9:00 to 5:00 Fax: (843) 332-3801 PCMH: No PCMH: No Mon, Thu 9:00 to 11:30 Tue - Wed, Fri 9:00 to 5:00 PCMH: No Patton, John MD Ear Nose & Throat Provider ID: 979192 Gender: Male Dyce, Orville MD Cardiac Electrophysiology Mcleod Cardiology Associates Provider ID: 1136015 Gender: Female Guha, Prabal MD 1319 S 4th St Hartsville, SC 29550-7458 Black Creek Medical Consultants Provider ID: 770147 LLC Gender: Male (843) 667-1891 Fax: (843) 665-2516 696 Medical Park Dr Mcleod Cardiology Associates Hartsville, SC 29550-4782 1319 S 4th St Mon - Fri 9:00 to 5:00 PCMH: No (843) 383-5312 Hartsville, SC 29550-7458 Fax: (843) 383-6501 (843) 667-1891 Mon - Fri 8:00 to 6:00 Fax: (843) 665-2516 Stellingworth, Mark MD PCMH: No Mon - Fri 9:00 to 5:00 Provider ID: 446038 PCMH: No Gender: Male Ph Medical Group Midlands Dyce, Orville MD Provider ID: 1136015 Cardiology 701 Medical Park Dr, Ste 301 Hartsville, SC 29550-4779 Gender: Female Bali, Arvind MD (843) 383-5978 149 E Carolina Ave Provider ID: 770214 Fax: (843) 383-5977 Hartsville, SC 29550-4213 Gender: Male Mon - Fri 8:30 to 5:00 (843) 383-5312 Hartsville Medical Group LLC PCMH: No Fax: (843) 383-6501 701 Medical Park Dr, Ste 302-303 PCMH: No Hartsville, SC 29550 Chiropractic (843) 383-5191 Family Practice Fax: (843) 383-4142 Bryan, John DC Carolina Pines Regional Medical Provider ID: 777292 Areephanthu, Abraham MD Center Gender: Male Provider ID: 773874 Mon - Fri 9:00 to 5:00 Pametto Wellness And Injury Gender: Male PCMH: No Center Apogee Medical Group Sc 331 S 4th St 1304 W Bobo Newsom Hwy Hartsville, SC 29550-4710 Grainger, Terry MD Hartsville, SC 29550-5734 (843) 332-6191 (843) 339-2100 Provider ID: 769872 Fax: (843) 339-4886 Gender: Male Fax: (843) 332-4408 Mon - Thu 8:30 to 5:30 Mon - Fri 9:00 to 5:00 Ph Medical Group Midlands PCMH: No 701 Medical Park Dr, Ste 301 Fri 8:30 to 1:00 Hartsville, SC 29550-4779 PCMH: No (843) 383-5978 Fax: (843) 383-5977 Mon - Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 30 38642781

Specialty Physicians Darlington Family Practice - cont. Lanning Lowther, Lisa DO Smith, Cory MD Provider ID: 942761 Provider ID: 773451 Brewton, Mary DO Gender: Female Gender: Male Provider ID: 1284030 Mcleod Urgent Care Darlington Mcleod Urgent Care Center Gender: Female 964 Lochend Dr 964 Lochend Dr Mcleod Urgent Care Darlington Darlington, SC 29532 Darlington, SC 29532 964 Lochend Dr (843) 777-6890 (843) 777-6890 Darlington, SC 29532 Fax: (843) 777-6891 Fax: (743) 777-6891 (843) 777-6890 Mon - Fri 8:00 to 8:00 Mon - Fri 9:00 to 5:00 Fax: (843) 777-6891 Sat - Sun 9:00 to 4:00 PCMH: No Mon - Fri 8:00 to 8:00 PCMH: No Sat - Sun 9:00 to 4:00 PCMH: No General Surgery Mohr, Richard MD Provider ID: 772678 Bannister, Carroll MD Crickman, Bonnie MD Gender: Male Provider ID: 774995 Provider ID: 775485 Mcleod Urgent Care Center Gender: Male Gender: Female 964 Lochend Dr Hartsville Surgical Center LLC Mcleod Urgent Care Centers Darlington, SC 29532 701 Medical Park Dr, Ste 101 964 Lochend Dr (843) 777-6890 Hartsville, SC 29550-4777 Darlington, SC 29532 Fax: (843) 777-6891 (843) 339-4295 (843) 777-6890 Mon - Fri 8:00 to 8:00 Fax: (843) 339-4609 Fax: (843) 777-6890 Sat 9:00 to 4:00 Mon - Fri 8:30 to 5:00 Mon - Fri 9:00 to 5:00 PCMH: No Sat 8:30 to 12:30 PCMH: No PCMH: No Padgett, Edwin MD Dickinson, Elizabeth MD Provider ID: 1491457 Bannister, Carroll MD Provider ID: 773733 Gender: Male Provider ID: 902239 Gender: Female Mcleod Urgent Care Darlington Gender: Male Mcleod Urgent Care Center 964 Lochend Dr Hartsville Medical Group LLC 964 Lochend Dr Darlington, SC 29532-5698 701 Medical Park Dr, Ste 101 Darlington, SC 29532 (843) 777-6890 Hartsville, SC 29550-4777 (843) 777-6890 Fax: (843) 777-6891 (843) 339-4295 Fax: (843) 777-6891 Mon - Fri 8:00 to 8:00 Fax: (843) 339-4609 Mon - Fri 8:00 to 8:00 Sat - Sun 9:00 to 4:00 Mon - Thu 8:30 to 5:00 Sat 9:00 to 4:00 PCMH: No Fri 8:30 to 12:00 PCMH: No PCMH: No Skinner, Motte MD Howington, Bryan MD Provider ID: 769517 Cooler, Arthur MD Provider ID: 1243609 Gender: Male Provider ID: 772116 Gender: Male Mcleod Urgent Care Darlington Gender: Male Mcleod Urgent Care Darlington 964 Lochend Dr Hartsville Surgical Center 964 Lochend Dr Darlington, SC 29532-5698 704 Medical Park Dr Darlington, SC 29532 (843) 777-6890 Hartsville, SC 29550 (843) 777-6890 Fax: (843) 777-6891 (843) 332-1099 Fax: (843) 777-6891 Mon - Fri 9:00 to 5:00 Fax: (843) 332-1091 Mon - Fri 8:00 to 8:00 PCMH: No Mon - Thu 8:30 to 5:00 Sat - Sun 9:00 to 4:00 Fri 8:30 to 12:30 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 31 38642781

Specialty Physicians Darlington General Surgery - cont. Hand Surgery Okoh, Samuel MD Provider ID: 1158733 Cooler, Arthur MD Litts, Christopher MD Gender: Male Provider ID: 772116 Provider ID: 1226038 Hartsville Medical Group LLC Gender: Male Gender: Male 701 Medical Park Dr, Ste 302-303 1304 W Bobo Newsom Hwy Mcleod Pee Dee Orthopedic Asso- Hartsville, SC 29550 Hartsville, SC 29550-4710 ciate (843) 383-3634 (843) 339-2100 1319 S 4th St Fax: (843) 383-4142 PCMH: No Hartsville, SC 29550-7458 Mon - Fri 8:00 to 5:00 (843) 662-5233 PCMH: No Dameron, Jason MD Fax: (843) 678-9003 Mon - Fri 9:00 to 5:00 Provider ID: 775186 Neuropsychology Gender: Male PCMH: No Hartsville Surgical Center West, Jesse PHD 704 Medical Park Dr Internal Medicine Provider ID: 1965193 Hartsville, SC 29550 Gender: Male (843) 332-1099 Quaye, Emmanuel MD Caresouth Carolina Inc Fax: (843) 332-1091 Provider ID: 770123 1268 S 4th St Mon - Thu 8:30 to 5:00 Gender: Male Hartsville, SC 29550-0703 Fri 8:30 to 12:30 Apogee Medical Group Sc (843) 332-3422 PCMH: No 1304 W Bobo Newsom Hwy, Fl 2 Fax: (843) 332-3985 Hartsville, SC 29550-4710 Mon - Fri 8:30 to 5:00 (843) 339-2100 Mincheff, Thomas MD Sat 9:00 to 1:00 Fax: (843) 339-4886 PCMH: No Provider ID: 774868 Mon - Fri 9:00 to 5:00 Gender: Male PCMH: No Hartsville Surgical Center Neuroradiology 704 Medical Park Dr Hartsville, SC 29550 Licensed Clinical Social Worker Edgar, Kenneth MD Provider ID: 1086977 (843) 332-1099 Penzo Shumard, Asya LMSW Fax: (843) 332-1091 Gender: Male Wed 2:00 to 5:00 Pee Dee Health Care Provider ID: 1268474 201 Cashua St Fri 9:00 to 12:00 Gender: Female PCMH: No Darlington, SC 29532-3301 Caresouth Carolina Inc. (843) 393-7452 737 S Main St Fax: (843) 395-8435 Sizemore, Patrick MD Society Hill, SC 29593 Mon - Fri 8:00 to 5:00 Provider ID: 1789085 (843) 378-4501 PCMH: No Gender: Male Mon - Fri 8:00 to 5:00 Hartsville Surgical Center LLC PCMH: No 704 Medical Park Dr Obstetrics/Gynecology Hartsville, SC 29550-4765 Nephrology Baroody, Brent MD (843) 332-1099 Provider ID: 1070547 Fax: (843) 332-1091 Govindappa, Venugopal MD Gender: Male Mon - Thu 8:30 to 5:00 Provider ID: 1226030 Lamar Family Care Fri 8:30 to 12:30 Gender: Male 301 W Main St PCMH: No 1308 S 4th St Lamar, SC 29069-7102 Hartsville, SC 29550-7447 (843) 395-8400 (843) 383-9526 Fax: (843) 395-8401 Fax: (843) 383-9577 Mon - Thu 8:00 to 5:00 PCMH: No Fri 8:00 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 32 38642781

Specialty Physicians Darlington Obstetrics/Gynecology - cont. Robinson, Leroy MD Karth, Peter MD Provider ID: 777216 Provider ID: 1777011 Baroody, Brent MD Gender: Male Gender: Male Provider ID: 1070547 Womens Care Caresouth Carolina Inc. Gender: Male 701 Medical Park Dr, Ste 202 737 S Main St Pee Dee Healthcare Hartsville, SC 29550 Society Hill, SC 29593-8972 201 Cashua St (843) 339-9222 (843) 857-0111 Darlington, SC 29532-3301 Fax: (843) 656-0102 Fax: (843) 857-0206 (843) 393-7452 Mon - Fri 9:00 to 5:00 Mon - Fri 8:30 to 5:00 Fax: (843) 395-8435 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Ophthalmology Seltzer, Samuel MD Provider ID: 1899328 Daniel, Scott MD Fishburne, Barron MD Gender: Male Provider ID: 771231 Provider ID: 907976 Clemson Eye Pa Gender: Male Gender: Male 504 S 4th St Womens Care Carolina Retina Center Pa Hartsville, SC 29550 701 Medical Park Dr, Ste 202 122 S 4th St (843) 664-9393 Hartsville, SC 29550-4765 Hartsville, SC 29550-4220 Fax: (843) 664-2301 (843) 339-9222 (803) 736-7200 Mon - Fri 8:00 to 4:30 Fax: (843) 339-2830 Fax: (803) 736-2116 PCMH: No Mon - Fri 9:00 to 5:00 Wed 8:30 to 5:00 PCMH: No PCMH: No Seltzer, Samuel MD Provider ID: 770236 Daniel, Scott MD Greene, Howard MD Gender: Male Provider ID: 771231 Provider ID: 1899332 Carolinas Centers For Sight PC Gender: Male Gender: Male 504 S 4th St 1304 W Bobo Newsom Hwy 504 S 4th Street Hartsville Hartsville, SC 29550-5720 Hartsville, SC 29550-4710 Hartsville, SC 29550 (843) 664-9393 (843) 339-2100 (864) 654-6706 Fax: (843) 664-2301 PCMH: No Fax: (864) 343-2074 Mon - Fri 8:00 to 4:30 Mon - Thu 8:00 to 5:30 PCMH: No Danzey, Toya MD Fri 8:00 to 5:00 PCMH: No Provider ID: 771119 Vasuki, Nagavivek MD Gender: Female Provider ID: 1899330 The Center For Womens Health Gross, Jeffrey MD Gender: Male 122 W College Ave Provider ID: 935679 Clemson Eye Pa Hartsville, SC 29550 Gender: Male 504 S 4th St (843) 383-8889 Carolina Retina Center Pa Hartsville, SC 29550-5720 Fax: (843) 383-8868 122 S 4th St (864) 654-6706 Mon - Fri 9:00 to 5:00 Hartsville, SC 29550-4220 Fax: (864) 343-2074 PCMH: No (803) 736-7200 Mon - Fri 8:00 to 5:30 Fax: (803) 736-2116 PCMH: No Quaye, Michelle MD Wed 8:30 to 5:00 Provider ID: 926676 PCMH: No Gender: Female Wellness Boutique LLC 107 W College Ave Hartsville, SC 29550-4113 (843) 639-6012 Fax: (843) 536-4194 Mon - Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 33 38642781

Specialty Physicians Darlington Optician Alexander, William OD Jones, Keith OD Provider ID: TPVALEX06-01 Provider ID: TPVJONE25-01 Eyes Over Carolina PC Gender: Male Gender: Male Provider ID: TPVEYES18-01 Clemson Eye Pa Jones Family Eyecare PC 1150 South 4th Street, Walmart 504 South Fourth Street 122 South 4th Street Vision Center 1135 Hartsville, SC 29550 Hartsville, SC 29550 Hartsville, SC 29550 (843) 332-7171 (843) 332-8323 (843) 857-1999 Fax: (843) 332-7802 Fax: (843) 332-2826 Fax: (843) 383-8951 Mon - Fri 8:00 to 5:00 Mon - Thu 8:00 to 5:30 Wed 9:00 to 6:00 PCMH: No Fri 8:00 to 5:00 PCMH: No PCMH: No Brinton, Evan OD Jones Family Eyecare PC Provider ID: TPVBRIN13-01 Jones, Jordi OD Provider ID: TPVJONE21-01 Gender: Male Provider ID: TPVJONE26-01 122 South 4th Street Eyes Over Carolina PC Gender: Female Hartsville, SC 29550 1150 South 4th Street, Walmart Jones Family Eyecare PC (843) 332-8323 Vision Center 1135 122 South 4th Street Fax: (843) 332-2826 Hartsville, SC 29550 Hartsville, SC 29550 Mon - Thu 8:00 to 5:30 (843) 857-1999 (843) 332-8323 Fri 8:00 to 5:00 Fax: (803) 227-8996 Fax: (843) 332-2826 PCMH: No Mon, Wed, Fri 9:00 to 6:00 Mon - Thu 8:00 to 5:30 PCMH: No Fri 8:00 to 5:00 Pee Dee Eye Associates PCMH: No Provider ID: TPVPEED01-01 Flowers, Stephen OD 504 South Fourth Street Provider ID: 2094653 Lemon, Edward OD Hartsville, SC 29550 Gender: Male Provider ID: TPVLEMO02-07 (843) 332-7171 Clemson Eye Pa Gender: Male Fax: (843) 332-7802 504 S 4th St Bergelt Optometric LLC Mon - Fri 8:00 to 5:00 Hartsville, SC 29550-5720 251 Andover Place PCMH: No (864) 654-6706 Darlington, SC 29532 Fax: (864) 343-2074 (843) 409-1954 Walmart Vision Center Mon - Fri 8:00 to 5:00 Fax: (843) 432-3189 Provider ID: TPVWALM40-04 PCMH: No Wed 9:00 to 4:00 1150 South 4th Street, Walmart PCMH: No Vision Center 1135 Flowers, Stephen OD Hartsville, SC 29550 Provider ID: TPVFLOW04-01 Mitchell, Edwin OD (843) 383-2013 Gender: Male Provider ID: TPVMITC17-08 Fax: (843) 383-8951 Clemson Eye Pa Gender: Male Mon - Sat 9:00 to 6:00 504 South Fourth Street Eyes Over Carolina PC PCMH: No Hartsville, SC 29550 1150 South 4th Street, Walmart (843) 332-7171 Vision Center 1135 Optometry Fax: (843) 332-7802 Hartsville, SC 29550 Mon - Fri 8:00 to 5:00 (843) 857-1999 Alexander, William OD PCMH: No Fax: (803) 227-8996 Provider ID: 2096140 Wed 9:00 to 6:00 Gender: Male PCMH: No Clemson Eye Pa 504 S 4th St Hartsville, SC 29550-5720 (864) 654-6706 Fax: (843) 332-7802 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 34 38642781

Specialty Physicians Darlington Optometry - cont. Scruggs, Miles OD Denton, Patrick MD Provider ID: TPVSCRU04-05 Provider ID: 776321 Newman, Ted OD Gender: Male Gender: Male Provider ID: 2094565 Eyes Over Carolina PC Mcleod Pee Dee Orthopedic Asso- Gender: Male 1150 South 4th Street, Walmart ciate Clemson Eye Pa Vision Center 1135 1319 S 4th St 504 S 4th St Hartsville, SC 29550 Hartsville, SC 29550-7458 Hartsville, SC 29550-5720 (843) 857-1999 (843) 662-5233 (843) 654-6706 Fax: (803) 227-8996 Fax: (843) 678-9003 Fax: (843) 343-2074 Mon, Wed, Fri 9:00 to 6:00 Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No Zeplin, Vincent OD Freeman, Gil MD Newman, Ted OD Provider ID: TPVZEPL01-22 Provider ID: 1651755 Provider ID: TPVNEWM11-01 Gender: Male Gender: Male Gender: Male Bergelt Optometric LLC Hartsville Medical Group LLC Clemson Eye Pa 1150 South 4th Street 700 Medical Park Dr 504 South Fourth Street Hartsville, SC 29550 Hartsville, SC 29550-4765 Hartsville, SC 29550 (843) 857-1999 (843) 383-3742 (843) 332-7171 Fax: (843) 432-3189 Fax: (843) 383-3745 Fax: (843) 332-7802 Mon 9:00 to 6:00 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No Orthopaedic Surgery Hassler, Terence MD Panicker, Jaison OD Provider ID: 962651 Provider ID: TPVPANI01-01 Badve, Siddharth MD Gender: Male Gender: Male Provider ID: 1366710 Hartsville Orthopedics And Sports Bergelt Optometric LLC Gender: Male M 251 Andover Place Hartsville Medical Group LLC 700 Medical Park Dr Darlington, SC 29532 700 Medical Park Dr Hartsville, SC 29550-4765 (843) 409-1954 Hartsville, SC 29550-4765 (843) 383-5191 Fax: (843) 432-3189 (843) 383-5191 Fax: (843) 383-3745 Mon - Wed 9:30 to 4:30 Fax: (843) 383-3745 Mon - Thu 8:30 to 5:30 PCMH: No Mon - Fri 8:00 to 5:00 Fri 8:00 to 3:00 PCMH: No PCMH: No Panicker, Jaison OD Provider ID: TPVPANI01-02 Clark, Barry DO Hassler, Terence MD Gender: Male Provider ID: 2399593 Provider ID: 962651 Bergelt Optometric LLC Gender: Male Gender: Male 1150 South 4th Street Hartsville Orthopedic And Sports 1304 W Bobo Newsom Hwy Hartsville, SC 29550 Me Hartsville, SC 29550-4710 (843) 857-1999 700 Medical Park Dr (843) 339-2100 Fax: (843) 432-3189 Hartsville, SC 29550-4765 PCMH: No Mon, Wed 9:00 to 6:00 (843) 383-3742 Tue 9:30 to 4:30 Fax: (843) 383-3745 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 35 38642781

Specialty Physicians Darlington Orthopaedic Surgery - cont. Sproul, Jack MD Khan, Sanaulla MD Provider ID: 1982052 Provider ID: 771631 Litts, Christopher MD Gender: Male Gender: Male Provider ID: 1226038 Hartsville Medical Group LLC DBA Mcleod Psychiatric Associates Gender: Male 701 Medical Park Dr, Ste 302-303 701 Cashua Ferry Rd Mcleod Pee Dee Orthopedic Asso- Hartsville, SC 29550-4777 Darlington, SC 29532 ciate (843) 383-3634 (843) 777-1100 1319 S 4th St Fax: (843) 383-4142 Fax: (843) 777-4296 Hartsville, SC 29550-7458 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 (843) 662-5233 PCMH: No PCMH: No Fax: (843) 678-9003 Mon - Fri 9:00 to 5:00 PCMH: No Wynkoop, Aaron MD Pulmonary Disease Provider ID: 2069382 Gender: Male Atkins III, John MD O'dell, Jason MD Hartsville Orthopedic And Sports Provider ID: 1765204 Provider ID: 771124 Me Gender: Male Gender: Male 700 Medical Park Dr Hartsville Medical Group LLC Mcleod Pee Dee Orthopedic Asso- Hartsville, SC 29550-4765 701 Medical Park Dr, Ste 208 ciate (843) 383-3742 Hartsville, SC 29550-4778 1319 S 4th St Fax: (843) 383-6456 (843) 339-3030 Hartsville, SC 29550-7458 Mon - Fri 8:30 to 5:00 Fax: (843) 383-0115 (843) 662-5233 PCMH: No Mon - Fri 8:00 to 5:00 Fax: (843) 678-9003 PCMH: No Mon - Fri 9:00 to 5:00 Psychiatry PCMH: No Barnard, Mark MD Ardaman, Miles MD Provider ID: 1235038 Prior, David MD Provider ID: 1563970 Gender: Male Provider ID: 2373120 Gender: Male Hartsville Medical Group Gender: Male Mcleod Psychiatric Associates 1304 W Bobo Newsom Hwy Hartsville Orthopedic And Sports 701 Cashua Ferry Rd Hartsville, SC 29550 Me Darlington, SC 29532-8488 (843) 339-3030 700 Medical Park Dr (843) 777-4200 Fax: (843) 383-0115 Hartsville, SC 29550-4765 Fax: (843) 777-4296 Mon - Sun 12:00 to 12:00 (843) 383-3742 Mon - Fri 9:00 to 5:00 PCMH: No Fax: (843) 383-3745 PCMH: No Mon - Fri 8:00 to 5:00 Govindappa, Venugopal MD PCMH: No Kayan, Sabih MD Provider ID: 1654754 Provider ID: 847791 Sproul, Jack MD Gender: Male Gender: Male Provider ID: 1982052 Mcleod Psychiatric Associates Hartsville Medical Group LLC Gender: Male 701 Cashua Ferry Rd 701 Medical Park Dr, Ste 302-303 Hartsville Medical Group LLC Darlington, SC 29532-8488 Hartsville, SC 29550-4778 700 Medical Park Dr (843) 777-4200 (843) 383-3634 Hartsville, SC 29550-4765 Fax: (843) 777-4296 Fax: (843) 383-4142 (843) 383-3742 Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 383-3745 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 36 38642781

Specialty Physicians Darlington Sports Medicine Denton, Patrick MD Provider ID: 776321 Gender: Male Mcleod Pee Dee Orthopedic Asso- ciate 1319 S 4th St Hartsville, SC 29550-7458 (843) 662-5233 Fax: (843) 678-9003 Mon - Fri 9:00 to 5:00 PCMH: No

Urology Horger, David MD Provider ID: 1549764 Gender: Male Hartsville Medical Group LLC 701 Medical Park Dr, Ste 110 Hartsville, SC 29550-4777 (843) 656-1204 Fax: (843) 656-1212 Mon - Fri 8:00 to 5:00 PCMH: No

Vaught, Winston MD Provider ID: 770202 Gender: Male The Medical Group Urology 701 Medical Park Dr, Ste 110 Hartsville, SC 29550 (843) 383-5191 Fax: (843) 383-0115 Mon - Fri 8:30 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 37 38642781

Specialty Physicians Dillon Chiropractic Family Practice Neurology Cline, Matthew DC Mitchell, Benjamin MD Abalsom, Nicholas MD Provider ID: 775347 Provider ID: 770467 Provider ID: 2296047 Gender: Male Gender: Male Gender: Male Advantage Health Center Of Dillon Mcleod Medical Center Dillion Mcleod Medical Center Dillon P 301 E Jackson St 301 East Jackson St 106 E Madison St Dillon, SC 29536-2509 Dillon, SC 29536-2509 Dillon, SC 29536 (843) 774-4111 (843) 777-5240 (843) 774-0440 Mon - Fri 9:00 to 5:00 Fax: (843) 777-5572 Fax: (843) 774-0477 PCMH: No Mon - Sun 12:00 to 12:00 Mon, Fri 11:00 to 7:00 PCMH: No Wed 7:00 to 7:00 General Surgery Thu 1:00 to 8:00 Aguilar, Maria MD PCMH: No Adams, Jessica DO Provider ID: 2296058 Provider ID: 1994924 Gender: Male Nodrick, Deborah MD Gender: Female Mcleod Medical Center Dillon Provider ID: 773027 Mcleod General Surgery Dillon 301 East Jackson St Gender: Female 705 N 8th Ave, Ste 2b Dillon, SC 29536-2509 Nodrick Chiropractic And Rehab- Dillon, SC 29536-2549 (843) 777-5240 ilita (843) 841-3846 Fax: (843) 777-5572 200 W Harrison St, Ste C Fax: (843) 841-3848 Mon - Sun 12:00 to 12:00 Dillon, SC 29536-3331 Mon - Fri 8:00 to 5:00 PCMH: No (843) 841-3911 PCMH: No Fax: (843) 841-3912 Almidani, Mazen MD Mon - Thu 8:00 to 6:00 Berglind, William MD Provider ID: 2318889 Fri 9:30 to 6:00 Provider ID: 1729496 Gender: Male PCMH: No Gender: Male Mcleod Medical Center Dillon Mcleod General Surgery Dillon 301 East Jackson St Schilsky, Suezen DC 705 N 8th Ave, Ste 2b Dillon, SC 29536-2509 Provider ID: 1271011 Dillon, SC 29536-2549 (843) 777-5240 Gender: Female (843) 841-3846 Fax: (843) 777-5572 Roff And Schilsky Chiropractic Cent Fax: (843) 841-3848 Mon - Sun 12:00 to 12:00 200 E Roosevelt St Mon - Fri 8:00 to 5:00 PCMH: No Dillon, SC 29536 PCMH: No (843) 627-3222 Amir, Murtaza MD Fax: (843) 627-3223 Dougherty, Joseph MD Provider ID: 2388389 Mon - Wed, Fri 8:30 to 5:30 Provider ID: 2334018 Gender: Female Thu 8:30 to 12:30 Gender: Male Mcleod Health Loris Seacoast PCMH: No Mcleod General Surgery Dillon 301 E Jackson St 705 N 8th Ave, Ste 2b Dillon, SC 29536-2509 Endocrinology Diabetes Metabolism Dillon, SC 29536-2549 (843) 777-5240 (843) 841-3846 Fax: (843) 777-5572 Mack, Aimar MD Fax: (843) 841-3848 Mon - Sun 12:00 to 12:00 Provider ID: 776633 Mon - Fri 8:00 to 5:00 PCMH: No Gender: Female PCMH: No 2376 Cypress Cir, Ste 202 Conway, SC 29526-8994 (843) 234-9700 Fax: (843) 234-6896 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 38 38642781

Specialty Physicians Dillon Neurology - cont. Borte, Bernadette MD Colongarcia, Patricia MD Provider ID: 2296081 Provider ID: 2313069 Avila, Amanda MD Gender: Female Gender: Female Provider ID: 2296062 Mcleod Medical Center Dillon Mcleod Medical Center Dillon Gender: Female 301 East Jackson St 301 E Jackson St Mcleod Medical Center Dillon Dillon, SC 29536-2509 Dillon, SC 29536-2509 301 East Jackson St (843) 777-5240 (843) 777-5240 Dillon, SC 29536-2509 Fax: (843) 777-5572 Fax: (843) 777-5572 (843) 777-5240 Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 Fax: (843) 777-5572 PCMH: No PCMH: No Mon - Sun 12:00 to 12:00 PCMH: No Boudreau, Michelle DO Corti, Sandro MD Provider ID: 2296089 Provider ID: 2318922 Baluja, Vivek MD Gender: Female Gender: Male Provider ID: 2296068 Mcleod Medical Center Dillon Mcleod Medical Center Dillon Gender: Male 301 East Jackson St 301 East Jackson St Mcleod Medical Center Dillon Dillon, SC 29536-2509 Dillon, SC 29536-2509 301 East Jackson St (843) 777-5240 (843) 777-5240 Dillon, SC 29536-2509 Fax: (843) 777-5572 Fax: (843) 777-5572 (843) 777-5240 Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 Fax: (843) 777-5572 PCMH: No PCMH: No Mon - Sun 12:00 to 12:00 PCMH: No Bradley, Nina DO Dhadwal, Neetu MD Provider ID: 2296091 Provider ID: 2296105 Behravan, Vahid MD Gender: Female Gender: Female Provider ID: 2296073 Mcleod Medical Center Dillon Mcleod Medical Center Dillon Gender: Male 301 East Jackson St 301 East Jackson St Mcleod Medical Center Dillon Dillon, SC 29536-2509 Dillon, SC 29536-2509 301 East Jackson St (843) 777-5240 (843) 777-5240 Dillon, SC 29536-2509 Fax: (843) 777-5572 Fax: (843) 777-5572 (843) 777-5240 Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 Fax: (843) 777-5572 PCMH: No PCMH: No Mon - Sun 12:00 to 12:00 PCMH: No Cheshire, Amanda MD Feliciano, Carlos MD Provider ID: 2296099 Provider ID: 2296106 Bixler, Christopher MD Gender: Female Gender: Male Provider ID: 2296076 Mcleod Medical Center Dillon Mcleod Medical Center Dillon Gender: Male 301 East Jackson St 301 East Jackson St Mcleod Medical Center Dillon Dillon, SC 29536-2509 Dillon, SC 29536-2509 301 East Jackson St (843) 777-5240 (843) 777-5240 Dillon, SC 29536-2509 Fax: (843) 777-5572 Fax: (843) 777-5572 (843) 777-5240 Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 Fax: (843) 777-5572 PCMH: No PCMH: No Mon - Sun 12:00 to 12:00 PCMH: No Chumble, Shubhangi MD Provider ID: 2296102 Gender: Female Mcleod Medical Center Dillon 301 East Jackson St Dillon, SC 29536-2509 (843) 777-5240 Fax: (843) 777-5572 Mon - Sun 12:00 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 39 38642781

Specialty Physicians Dillon Neurology - cont. Heller, Adam MD Li, Sui MD Provider ID: 2296141 Provider ID: 2318939 Figueroa Garcia, Alberto MD Gender: Male Gender: Male Mcleod Medical Center Dillon Mcleod Medical Center Dillon Provider ID: 2309820 301 East Jackson St 301 East Jackson St Gender: Male Dillon, SC 29536-2509 Dillon, SC 29536-2509 Mcleod Medical Center Dillon (843) 777-5240 (843) 777-5240 301 E Jackson St Fax: (843) 777-5572 Fax: (843) 777-5572 Dillon, SC 29536-2509 Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 (843) 774-4111 PCMH: No PCMH: No Fax: (843) 774-4000 Mon - Sun 12:00 to 12:00 PCMH: No Jimenez-Sanders, Rebecca MD Lue, Stanley MD Provider ID: 2296149 Provider ID: 2296144 Gender: Male Floyd, Jessica MD Gender: Female Mcleod Medical Center Dillon Provider ID: 2296118 Mcleod Medical Center Dillon 301 East Jackson St Gender: Female 301 East Jackson St Dillon, SC 29536-2509 Mcleod Medical Center Dillon Dillon, SC 29536-2509 (843) 777-5240 301 East Jackson St (843) 777-5240 Fax: (843) 777-5572 Dillon, SC 29536-2509 Fax: (843) 777-5572 Mon - Sun 12:00 to 12:00 (843) 777-5240 Mon - Sun 12:00 to 12:00 PCMH: No Fax: (843) 777-5572 PCMH: No Mon - Sun 12:00 to 12:00 PCMH: No Masud, Muhammad MD Khishchenko, Natan MD Provider ID: 2296151 Provider ID: 2318929 Gender: Male Friedman, Mark DO Gender: Male Mcleod Medical Center Dillon Provider ID: 2296124 Mcleod Medical Center Dillon 301 East Jackson St Gender: Male 301 East Jackson St Dillon, SC 29536-2509 Mcleod Medical Center Dillon Dillon, SC 29536-2509 (843) 777-5240 301 East Jackson St (843) 777-5240 Fax: (843) 777-5572 Dillon, SC 29536-2509 Fax: (843) 777-5572 Mon - Sun 12:00 to 12:00 (843) 777-5240 Mon - Sun 12:00 to 12:00 PCMH: No Fax: (843) 777-5572 PCMH: No Mon - Sun 12:00 to 12:00 PCMH: No Mcdonald, Mark MD Lamar, Cory MD Provider ID: 2309837 Provider ID: 2296147 Gender: Male Gupta, Raina MD Gender: Male Mcleod Medical Center Dillon Provider ID: 2296134 Mcleod Medical Center Dillon 301 E Jackson St Gender: Female 301 East Jackson St Dillon, SC 29536-2509 Mcleod Medical Center Dillon Dillon, SC 29536-2509 (843) 777-5240 301 East Jackson St (843) 777-5240 Fax: (843) 777-5572 Dillon, SC 29536-2509 Fax: (843) 777-5572 Mon - Sun 12:00 to 12:00 (843) 777-5240 Mon - Sun 12:00 to 12:00 PCMH: No Fax: (843) 777-5572 PCMH: No Mon - Sun 12:00 to 12:00 PCMH: No Mednick, Adam MD Provider ID: 2296158 Gender: Male Mcleod Medical Center Dillon 301 East Jackson St Dillon, SC 29536-2509 (843) 777-5240 Fax: (843) 777-5572 Mon - Sun 12:00 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 40 38642781

Specialty Physicians Dillon Neurology - cont. Murtaza, Amir MD Plancher, Joao Mc-Oneil MD Provider ID: 2318960 Mendelson, Joshua MD Gender: Male Provider ID: 2296180 Provider ID: 2318945 Mcleod Medical Center Dillon Gender: Male Gender: Male 301 East Jackson St Mcleod Medical Center Dillon Mcleod Medical Center Dillon Dillon, SC 29536-2509 301 East Jackson St 301 East Jackson St (843) 777-5240 Dillon, SC 29536-2509 Dillon, SC 29536-2509 Fax: (843) 777-5572 (843) 777-5240 (843) 777-5240 Mon - Sun 12:00 to 12:00 Fax: (843) 777-5572 Fax: (843) 777-5572 PCMH: No Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 PCMH: No PCMH: No Nagaraja, Harsha MD Provider ID: 2296176 Riordan, Katherine MD Meyers, Clifford MD Gender: Male Provider ID: 2296187 Provider ID: 2296173 Mcleod Medical Center Dillon Gender: Female Gender: Male 301 East Jackson St Mcleod Medical Center Dillon Mcleod Medical Center Dillon Dillon, SC 29536-2509 301 East Jackson St 301 East Jackson St (843) 777-5240 Dillon, SC 29536-2509 Dillon, SC 29536-2509 Fax: (843) 777-5572 (843) 777-5240 (843) 777-5240 Mon - Sun 12:00 to 12:00 Fax: (843) 777-5572 Fax: (843) 777-5572 PCMH: No Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 PCMH: No PCMH: No Newman, Richard MD Provider ID: 2318967 Saha, Sam MD Mojumder, Deb MD Gender: Male Provider ID: 2296191 Provider ID: 2296162 Mcleod Medical Center Dillon Gender: Male Gender: Male 301 East Jackson St Mcleod Medical Center Dillon Mcleod Medical Center Dillon Dillon, SC 29536-2509 301 East Jackson St 301 East Jackson St (843) 777-5240 Dillon, SC 29536-2509 Dillon, SC 29536-2509 Fax: (843) 777-5572 (843) 777-5240 (843) 777-5240 Mon - Sun 12:00 to 12:00 Fax: (843) 777-5572 Fax: (843) 777-5572 PCMH: No Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 PCMH: No PCMH: No Null, Elizabeth MD Provider ID: 2318968 Sebesto, Jason DO Mowzoon, Mina MD Gender: Female Provider ID: 2296197 Provider ID: 2296165 Mcleod Medical Center Dillon Gender: Male Gender: Male 301 East Jackson St Mcleod Medical Center Dillon Mcleod Medical Center Dillon Dillon, SC 29536-2509 301 East Jackson St 301 East Jackson St (843) 777-5240 Dillon, SC 29536-2509 Dillon, SC 29536-2509 Fax: (843) 777-5572 (843) 777-5240 (843) 777-5240 Mon - Sun 12:00 to 12:00 Fax: (843) 777-5572 Fax: (843) 777-5572 PCMH: No Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 PCMH: No PCMH: No Patel, Neil MD Provider ID: 2318971 Gender: Male Mcleod Medical Center Dillon 301 East Jackson St Dillon, SC 29536-2509 (843) 777-5240 Fax: (843) 777-5572 Mon - Sun 12:00 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 41 38642781

Specialty Physicians Dillon Neurology - cont. Vajapey, Geetanjali MD Zaman, Mohammed DO Provider ID: 2296230 Provider ID: 2296247 Sevilis, Theresa DO Gender: Female Gender: Male Provider ID: 2296203 Mcleod Medical Center Dillon Mcleod Medical Center Dillon Gender: Female 301 East Jackson St 301 East Jackson St Mcleod Medical Center Dillon Dillon, SC 29536-2509 Dillon, SC 29536-2509 301 East Jackson St (843) 777-5240 (843) 777-5240 Dillon, SC 29536-2509 Fax: (843) 777-5572 Fax: (843) 777-5572 (843) 777-5240 Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 Fax: (843) 777-5572 PCMH: No PCMH: No Mon - Sun 12:00 to 12:00 PCMH: No Valanta, Douglas MD Obstetrics/Gynecology Provider ID: 2296236 Snyder, Michael MD Gender: Male Caron, Philip DO Provider ID: 2296207 Mcleod Medical Center Dillon Provider ID: 2306013 Gender: Male 301 East Jackson St Gender: Male Mcleod Medical Center Dillon Dillon, SC 29536-2509 Mcleod Ob/Gyn Dillon 301 East Jackson St (843) 777-5240 706 N 8th Ave Dillon, SC 29536-2509 Fax: (843) 777-5572 Dillon, SC 29536-2540 (843) 777-5240 Mon - Sun 12:00 to 12:00 (843) 841-3825 Fax: (843) 777-5572 PCMH: No Fax: (843) 841-3830 Mon - Sun 12:00 to 12:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Vega, Jose MD Provider ID: 2309880 Sombutmai, Chut DO Gender: Male Clarke, Cheryl MD Provider ID: 2296211 301 E Jackson St Provider ID: 1798835 Gender: Male Dillon, SC 29536-2509 Gender: Female Mcleod Medical Center Dillon (843) 777-5240 Mcleod Ob/Gyn Dillon 301 East Jackson St Fax: (843) 777-5572 706 N 8th Ave Dillon, SC 29536-2509 Mon - Sun 12:00 to 12:00 Dillon, SC 29536-2540 (843) 777-5240 PCMH: No (843) 841-3825 Fax: (843) 777-5572 Fax: (843) 841-3830 Mon - Sun 12:00 to 12:00 Mon - Fri 8:00 to 5:00 PCMH: No Vidgop, Yelana MD PCMH: No Provider ID: 2309865 Gender: Female Tigist, Mehari MD Mcleod Medical Center Dillon Climer, Clyde MD Provider ID: 2318987 301 E Jackson St Provider ID: 1289784 Gender: Female Dillon, SC 29536-2509 Gender: Male Mcleod Medical Center Dillon (843) 777-5240 Mcleod Ob/Gyn-Dillon 301 East Jackson St Fax: (843) 777-5572 705 N 8th Ave, Ste 3b Dillon, SC 29536-2509 Mon - Sun 12:00 to 12:00 Dillon, SC 29536-2549 (843) 777-5240 PCMH: No (843) 841-3825 Fax: (843) 777-5572 Fax: (843) 841-3830 Mon - Sun 12:00 to 12:00 Mon - Fri 8:00 to 6:00 PCMH: No Won, Mai MD PCMH: No Provider ID: 2296245 Gender: Female Mcleod Medical Center Dillon 301 East Jackson St Dillon, SC 29536-2509 (843) 777-5240 Fax: (843) 777-5572 Mon - Sun 12:00 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 42 38642781

Specialty Physicians Dillon Obstetrics/Gynecology - cont. Jones, Stephen MD Moore, Dorwin MD Provider ID: 1993287 Provider ID: 1690552 Durst, John MD Gender: Male Gender: Male Provider ID: 1829321 Mcleod Ob/Gyn Dillon Mcleod Ob/Gyn Dillon Gender: Male 706 N 8th Ave 706 N 8th Ave Mcleod OBGYN Dillon Dillon, SC 29536-2540 Dillon, SC 29536-2540 706 N 8th Ave (843) 841-3825 (843) 841-3825 Dillon, SC 29536-2540 Fax: (843) 841-3830 Fax: (843) 841-3830 (843) 841-3825 Mon - Fri 8:00 to 5:00 Mon - Thu 8:00 to 5:00 Fax: (843) 777-7422 PCMH: No Fri 8:00 to 1:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Keeton, Janis MD Provider ID: 2383490 Schindler, Joycelyn MD Faiyaz, Seema MD Gender: Female Provider ID: 970568 Provider ID: 1838054 Mcleod Ob/Gyn Dillon Gender: Female Gender: Female 706 N 8th Ave Mcleod OBGYN Dillon Mcleod Ob/Gyn Dillon Dillon, SC 29536-2540 705 N 8th Ave, Ste 3b 706 N 8th Ave (843) 841-3825 Dillon, SC 29536-2549 Dillon, SC 29536-2540 Fax: (843) 841-3830 (843) 841-3825 (843) 841-3825 Mon - Fri 8:00 to 5:00 Fax: (843) 841-3830 Fax: (843) 841-3830 PCMH: No Mcleod Loris Seacoast Ho Languages: Hindi, Spanish Languages: Tagalog Mon - Fri 8:00 to 5:00 Mon - Fri 9:00 to 5:00 PCMH: No Kolb, Cynthia MD Provider ID: 774288 PCMH: No Gender: Female Hoffman, Michael MD Mcleod Ob/Gyn Dillon Ophthalmology Provider ID: 1162575 705 N 8th Ave, Ste 3b Gender: Male Dillon, SC 29536-2549 Seltzer, Samuel MD Mcleod OBGYN Dillon (843) 841-3825 Provider ID: 1899328 705 N 8th Ave, Ste 3b Fax: (843) 841-3830 Gender: Male Dillon, SC 29536-2549 Mon - Fri 9:00 to 5:00 Clemson Eye Pa (843) 841-3825 PCMH: No 300 E Monroe St Fax: (843) 841-3830 Dillon, SC 29536 Mon - Fri 9:00 to 5:00 (843) 664-9393 PCMH: No Lusk, Clifford MD Fax: (843) 664-2301 Provider ID: 773596 Mon - Fri 8:00 to 5:00 Gender: Male PCMH: No Hughes, Chelsea MD Mcleod Ob/Gyn Dillon Provider ID: 2382441 706 N 8th Ave, Ste 430 Gender: Female Dillon, SC 29536-2540 Seltzer, Samuel MD Mcleod Ob/Gyn Dillon (843) 841-3825 Provider ID: 770236 706 N 8th Ave Fax: (843) 841-3830 Gender: Male Dillon, SC 29536-2540 Mon - Fri 8:00 to 5:00 Carolinas Centers For Sight PC (843) 841-3825 PCMH: No 300 E Monroe St Fax: (843) 841-3830 Dillon, SC 29536-2559 Mon - Fri 8:00 to 5:00 (843) 664-9393 PCMH: No Fax: (843) 664-2301 Mon - Fri 8:00 to 4:30 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 43 38642781

Specialty Physicians Dillon Ophthalmology - cont. Sutton, Michael DO Provider ID: 772509 Vasuki, Nagavivek MD Gender: Male Provider ID: 1899330 301 E Jackson St Gender: Male Dillon, SC 29536-2509 Clemson Eye Pa (843) 774-4111 300 E Monroe St PCMH: No Dillon, SC 29536 (843) 664-9393 Mon - Fri 8:00 to 5:00 Psychology PCMH: No Jasper, Kendell PHD Provider ID: 1243608 Optometry Gender: Male Jasper Psychological Services PLLC Gaddy, Mckethan OD 1508b Highway 301 N Provider ID: 2094644 Dillon, SC 29536 Gender: Male (704) 910-5395 Clemson Eye Pa Fax: (704) 791-0560 300 E Monroe St Mon 11:00 to 1:00 Dillon, SC 29536-2560 Tue 12:00 to 5:00 (864) 654-6706 PCMH: No Fax: (864) 343-2074 Mon - Fri 8:30 to 5:00 PCMH: No Urology Fukuda, Christopher MD Gaddy, Mckethan OD Provider ID: 1190179 Provider ID: TPVMCKE22-01 Gender: Male Gender: Male Mcleod Urology Associates Clemson Eye Pa 705 N 8th Ave 300 East Monroe Street Dillon, SC 29536-2549 Dillon, SC 29536 (843) 777-7555 (864) 654-6706 Fax: (843) 777-7563 Fax: (864) 343-2074 Mon - Fri 9:00 to 5:00 Mon - Thu 8:00 to 5:30 PCMH: No Fri 8:00 to 5:00 PCMH: No

Orthopaedic Surgery Sutton, Michael DO Provider ID: 772509 Gender: Male Mcleod Orthopaedic Of Dillon 705 N 8th Ave, Ste 1b Dillon, SC 29536-2549 (843) 487-1588 Fax: (843) 487-1590 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 44 38642781

Specialty Physicians Florence Allergy & Immunology Imbeau, Stephen MD Kocherla, Cyrus MD Provider ID: 775592 Provider ID: 2312801 Crouch, Timothy MD Gender: Male Gender: Male Provider ID: 775082 Allergy Asthma And Sinus Center Mcleod Cardiology Associates Gender: Male 800 E Cheves St, Ste 420 101 William H Johnson St, Ste 600 Allergy Asthma And Sinus Center Florence, SC 29506 Florence, SC 29506-2773 800 E Cheves St, Ste 420 (843) 679-9335 (843) 667-1891 Florence, SC 29506-2606 Fax: (843) 679-9294 Fax: (843) 665-2516 (843) 679-9335 Mon - Fri 8:30 to 5:30 Mon - Fri 8:00 to 5:00 Fax: (843) 679-9294 PCMH: No PCMH: No Mon, Thu 9:00 to 5:00 Tue 9:00 to 11:30 Wed, Fri 9:00 to 4:00 Moyer, Joseph MD Cardiology PCMH: No Provider ID: 770623 Gender: Male Blaker, Alan MD Allergy Asthma And Sinus Center Provider ID: 771656 Douglas, Danny MD 800 E Cheves St, Ste 420 Gender: Male Provider ID: 770019 Florence, SC 29506-2606 Mcleod Cardiology Associates Gender: Male (843) 679-9335 101 William H Johnson St, Ste 600 Allergy Asthma And Sinus Center Fax: (843) 679-9294 Florence, SC 29506-2779 PC Mon - Fri 8:30 to 5:30 (843) 667-1891 3980 Hwy 9 East, Ste 260 PCMH: No Fax: (843) 665-2516 Florence, SC 29506-2606 Mcleod Regional Medical Center (843) 399-9033 Mon - Fri 9:00 to 5:00 Fax: (843) 399-9051 Stone, Harry MD PCMH: No Mon - Fri 8:30 to 5:30 Provider ID: 777042 PCMH: No Gender: Male Allergy Asthma Sinus Center Debsikdar, Jaideep MD 800 E Cheves St, Ste 420 Provider ID: 1843187 Douglas, Danny MD Florence, SC 29506 Gender: Male Provider ID: 770019 (843) 679-9335 Advanced Cardiology Consultants Gender: Male Fax: (843) 669-4214 P. Allergy Asthma And Sinus Center Mon - Fri 8:30 to 5:30 1706 2nd Loop Rd PC PCMH: No Florence, SC 29501-6119 5046 Hwy 17 Bypass S, Ste 105 (843) 629-8084 Florence, SC 29506-2606 Fax: (843) 629-8684 (843) 293-5000 Cardiac Electrophysiology Mon - Fri 8:30 to 5:00 Fax: (843) 293-4748 Guha, Prabal MD PCMH: No Mon - Fri 8:30 to 5:30 Provider ID: 770147 PCMH: No Gender: Male Guha, Prabal MD Mcleod Cardiology Associates Provider ID: 770147 Douglas, Danny MD 101 William H Johnson St, Ste 600 Gender: Male Provider ID: 770019 Florence, SC 29506-2779 Mcleod Cardiology Associates Gender: Male (843) 667-1891 101 William H Johnson St, Ste 600 800 E Cheves St, Ste 420 Fax: (843) 665-2516 Florence, SC 29506-2779 Florence, SC 29506-2649 Mon - Fri 8:00 to 5:00 (843) 667-1891 (843) 679-9335 PCMH: No Fax: (843) 665-2516 Fax: (843) 669-4214 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 45 38642781

Specialty Physicians Florence Cardiology - cont. Naso, Nicolette MD Stoughton, Thomas MD Provider ID: 776451 Provider ID: 772064 Holland, Evans MD Gender: Female Gender: Male Provider ID: 774657 Mcleod Cardiology Associates Mcleod Cardiology Associates Gender: Male 101 William H Johnson St, Ste 600 101 Johns St, Ste 600 Pee Dee Cardiology Associates Florence, SC 29506-2779 Florence, SC 29506-2779 101 William H Johnson St, Ste 600 (843) 667-1891 (843) 667-1891 Mcleod Medical Park East Fax: (843) 665-2516 Fax: (843) 665-2516 Florence, SC 29506 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 (843) 667-1891 PCMH: No PCMH: No Fax: (843) 662-9651 Mon - Fri 9:00 to 5:00 PCMH: No Naso, Nicolette MD Chiropractic Provider ID: 776452 Gender: Female Bergrin, Jon DC Holland, Evans MD Pee Dee Cardiology Assoc Provider ID: 771838 Provider ID: 774657 901 E Cheves St, Ste 600 Gender: Male Gender: Male Florence, SC 29506 Family Neck And Back Center Pee Dee Cardiology Associates (843) 667-1891 405 S Ebenezer Rd 901 E Cheves St, Ste 600 Fax: (843) 665-2516 Florence, SC 29501 Florence, SC 29506 Mon - Fri 8:00 to 5:00 (843) 662-4341 (843) 667-1891 PCMH: No Fax: (843) 679-3060 Fax: (843) 665-2516 Mon - Fri 7:00 to 6:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Om, Anil MD Provider ID: 777235 Gender: Male Edwards II, Ira DC Karrowni, Wassef MD Mcleod Cardiology Associates Provider ID: 1604440 Provider ID: 1849561 101 William H Johnson St, Ste 600 Gender: Male Gender: Male Florence, SC 29506-2779 Palmetto Wellness And Injury Musc Physicians Cardiology (843) 667-1891 Cente Florence Fax: (843) 665-2516 436 W Palmetto St, Ste B 805 Pamplico Hwy, Ste B230 Mon - Fri 8:00 to 5:00 Florence, SC 29501-4425 Florence, SC 29505 PCMH: No (843) 665-7110 (843) 674-2955 Fax: (843) 665-1282 Fax: (843) 664-9863 Mon - Thu 8:30 to 5:30 Musc Health Florence Medical Patton, John MD Fri 8:30 to 1:00 Center Provider ID: 979192 PCMH: No Mon - Fri 8:00 to 5:00 Gender: Male PCMH: No Mcleod Cardiology Associates 101 William H Johnson St, Ste 600 Ferrigno, Michael DC Florence, SC 29506-2779 Provider ID: 774729 Lee, James MD (843) 667-1891 Gender: Male Provider ID: 772459 Fax: (843) 665-2516 Ferrigno Healthcare Gender: Male Mon - Fri 8:00 to 5:00 2554 W Palmetto St Pee Dee Cardiology Associates Pa PCMH: No Florence, SC 29501 901 E Cheves St, Ste 600 (843) 662-2110 Florence, SC 29506 Fax: (843) 662-1991 (843) 667-1891 Rahman, Ossama MD Mon, Thu - Fri 8:00 to 6:00 Fax: (843) 665-2516 Provider ID: 1849506 PCMH: No Mon - Fri 8:00 to 5:00 Gender: Male PCMH: No 1594 Freedom Blvd, Bldg C100 Florence, SC 29505 (843) 674-4787 Musc Health Florence Medical Center PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 46 38642781

Specialty Physicians Florence Chiropractic - cont. Patel, Kunal DC Hopla, Dan MD Provider ID: 1581742 Provider ID: 772332 Gittens, David DC Gender: Male Gender: Male Provider ID: 1173946 Hopehealth Irby Ear Nose Throat Associates Gender: Male 360 N Irby St 800 E Cheves St, Ste 370 Gitten Chiropractic Clinic Florence, SC 29501-2808 Florence, SC 29506-2649 333 W Palmetto St (843) 667-9414 (843) 667-3533 Florence, SC 29501 Fax: (843) 667-1362 Fax: (843) 292-0038 (843) 678-9394 Mon - Fri 8:00 to 8:00 Mon - Fri 9:00 to 5:00 Fax: (843) 678-9909 PCMH: No PCMH: No Mon - Wed 8:30 to 6:00 Thu 8:30 to 7:00 Fri 8:30 to 1:30 Stone, Amanda DC Mckay, Shawn MD PCMH: No Provider ID: 1648406 Provider ID: 770584 Gender: Female Gender: Male Family Neck Back Center Florence Ears Nose Throat PC Hutcheson, Brian DC 405 S Ebenezer Rd 1521 Mclure Ct Provider ID: 1229195 Florence, SC 29501-7916 Florence, SC 29505-6174 Gender: Male (843) 662-4341 (843) 665-2900 Hopehealth Inc Fax: (843) 679-3060 Fax: (843) 629-8122 600 E Palmetto St Mon - Thu 7:00 to 6:00 Mon - Fri 8:00 to 5:00 Florence, SC 29506 Fri 8:00 to 5:00 PCMH: No (843) 667-9414 PCMH: No Fax: (843) 667-1362 Mon - Fri 7:30 to 5:00 Rosi, David DO PCMH: No Wenner, Bryan DC Provider ID: 1259155 Provider ID: 774583 Gender: Male Gender: Male Mcleod ENT Associates Hutcheson, Brian DC Palmetto Chiropractic Neck Back 800 E Cheves St, Ste 370 Provider ID: 1229195 Ce Florence, SC 29506 Gender: Male 2147 Hoffmeyer Rd, Ste A (843) 667-3533 Hopehealth Irby Florence, SC 29501 Fax: (843) 292-0038 360 N Irby St (843) 662-8000 Mon - Fri 8:30 to 5:00 Florence, SC 29501-2808 Fax: (843) 664-0994 PCMH: No (843) 667-9414 Mon - Thu 8:30 to 6:00 Fax: (843) 667-1362 Fri 8:30 to 5:00 Rosi, David DO Mon - Fri 8:00 to 8:00 PCMH: No PCMH: No Provider ID: 2322842 Gender: Male Ear Nose & Throat Florence Ears Nose And Throat Jordan, Chucky DC 1521 Mclure Ct Provider ID: 1353712 Farrell, Howard MD Florence, SC 29505-6174 Gender: Male Provider ID: 771638 (843) 665-2900 Biospine Health And Wellness LLC Gender: Male Fax: (843) 629-8122 1800 2nd Loop Rd, Ste 8 Florence Ears Nose Throat PC Mon - Fri 8:30 to 5:00 Florence, SC 29501 1521 Mclure Ct PCMH: No (843) 713-0669 Florence, SC 29505-6174 Fax: (866) 663-0329 (843) 665-2900 Mon - Thu 9:00 to 6:00 Fax: (843) 629-8122 Fri 8:00 to 1:00 Mon - Thu 8:00 to 5:00 PCMH: No Fri 8:00 to 2:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 47 38642781

Specialty Physicians Florence Endocrinology Diabetes Metabolism Family Practice Howington, Bryan MD Provider ID: 1243609 Culleton, John MD Brewton, Mary DO Gender: Male Provider ID: 1818284 Provider ID: 1284030 Mcleod Urgent Care Center Gender: Male Gender: Female 3015 W Palmetto St Hopehealth Irby Mcleod Urgent Care Centers Florence, SC 29501-5935 360 N Irby St 3015 W Palmetto St (843) 777-6870 Florence, SC 29501-2808 Florence, SC 29501 Fax: (843) 777-6871 (843) 667-9414 (843) 777-6870 Mon - Fri 8:00 to 8:00 Fax: (843) 667-1362 Fax: (843) 777-6871 Sat - Sun 9:00 to 4:00 Languages: Spanish Mon - Fri 8:00 to 8:00 PCMH: No Mon - Sat 8:00 to 8:00 Sat - Sun 9:00 to 4:00 PCMH: No PCMH: No James, Kiasha MD Provider ID: 774099 Pande, Meenakshi MD Bruce, Valarian MD Gender: Female Provider ID: 812871 Provider ID: 1026742 Mcleod Regional Medical Ctr Gender: Female Gender: Male Hospita Musc Physicians Endocrinology Mcleod Urgent Care Center 555 E Cheves St Flore 3015 W Palmetto St Florence, SC 29506-2617 1594 Freedom Blvd, Ste 205 Florence, SC 29501-5935 (843) 777-2000 Florence, SC 29505-6046 (843) 777-6870 Mon - Fri 9:00 to 5:00 (843) 673-7560 Fax: (843) 777-6871 PCMH: No Fax: (843) 673-7563 Mon - Fri 8:00 to 9:00 Musc Health Florence Medical Sat - Sun 9:00 to 4:00 Center PCMH: No Jebaily, Deann DO Mon - Fri 8:00 to 5:00 Provider ID: 769766 PCMH: No Gender: Female Crickman, Bonnie MD Mcleod Regional Medical Center Provider ID: 775485 555 E Cheves St Shenouda, Hany MD Gender: Female Florence, SC 29506 Provider ID: 1729255 Mcleod Urgent Care Centers (843) 777-2000 Gender: Male 3015 W Palmetto St Mon - Fri 9:00 to 5:00 Mcleod Endocrinology Associates Florence, SC 29501 PCMH: No 101 S Ravenel St, Ste 300 (843) 777-6870 Florence, SC 29506-2618 Fax: (843) 777-6871 (843) 777-7490 Mon - Fri 9:00 to 5:00 Lanning Lowther, Lisa DO Fax: (843) 777-7480 PCMH: No Provider ID: 942761 Mon - Thu 8:00 to 5:00 Gender: Female Mcleod Urgetn Care Centers Fri 8:00 to 12:00 Dickinson, Elizabeth MD PCMH: No 3015 W Palmetto St Provider ID: 773733 Florence, SC 29501 Gender: Female (843) 777-6870 Wilkins, Francesca MD Mcleod Urgent Care Center Fax: (843) 777-6871 Provider ID: 1434917 3015 W Palmetto St Mon - Fri 8:00 to 8:00 Gender: Female Florence, SC 29501 Sat - Sun 9:00 to 4:00 Mcleod Endocrinology Associates (843) 777-6870 PCMH: No 101 S Ravenel St, Ste 300 Fax: (843) 777-6871 Florence, SC 29506-2621 Mon - Fri 8:00 to 8:00 (843) 777-7490 Sat - Sun 9:00 to 3:00 Fax: (843) 777-7480 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 48 38642781

Specialty Physicians Florence Family Practice - cont. Padgett, Edwin MD Strauss, Louis MD Provider ID: 1491457 Provider ID: 1600296 Miranda, Roberto MD Gender: Male Gender: Male Provider ID: 1007106 Mcleod Urgent Care Center Mcleod Health Florence Gender: Male 3015 W Palmetto St 555 E Cheves St Musc Physicians Primary Care Florence, SC 29501-5935 Florence, SC 29506-2617 Vance (843) 777-6870 (843) 777-2000 2501 S Vance Dr, Ste A Fax: (843) 777-6886 Mon - Sun 12:00 to 12:00 Florence, SC 29505-6163 Mon - Fri 8:00 to 8:00 PCMH: No (843) 679-4019 Sat - Sun 9:00 to 4:00 Fax: (843) 679-4022 PCMH: No Musc Health Florence Medical Zeleke, Akal MD Center Provider ID: 2313398 Mon - Fri 8:00 to 5:00 Singh, Navdeep MD Gender: Female PCMH: No Provider ID: 769580 Mcleod Regional Medical Center Gender: Female 555 E Cheves St Mcleod Family Medicine Center Florence, SC 29506-2617 Mohr, Richard MD 555 E Cheves St (843) 777-5246 Provider ID: 772678 Florence, SC 29506 Fax: (843) 777-5572 Gender: Male (843) 777-2800 Mon - Sun 12:00 to 12:00 Mcleod Urgent Care Center Fax: (843) 777-5350 PCMH: No 3015 W Palmetto St Mon - Fri 8:30 to 5:00 Florence, SC 29501 PCMH: No (843) 777-6870 Gastroenterology Fax: (843) 777-6871 Ansari, Shoukath MD Mon - Fri 8:00 to 8:00 Skinner, Motte MD Provider ID: 769517 Provider ID: 1163119 Sat - Sun 9:00 to 4:00 Gender: Male PCMH: No Gender: Male Mcleod Urgent Care Center Mcleod Digestive Health Center 3015 W Palmetto St 401 East Cheves St, Ste 301 Morgan, Patrick MD Florence, SC 29501-5935 Florence, SC 29506-2615 Provider ID: 964823 (843) 777-6870 (843) 777-7166 Gender: Male Fax: (843) 777-6871 Fax: (843) 777-7167 Mcleod Urgent Care Center Mon - Wed 8:30 to 5:00 Languages: Tamil 3015 W Palmetto St Thu - Fri 9:00 to 5:00 Mon - Fri 9:00 to 5:00 Florence, SC 29501-5935 PCMH: No PCMH: No (843) 777-6870 Fax: (843) 777-6871 Ansari, Shoukath MD Mon - Fri 8:00 to 8:00 Smith, Cory MD Provider ID: 773451 Provider ID: 1163119 Sat - Sun 9:00 to 8:00 Gender: Male PCMH: No Gender: Male Mcleod Urgent Care Center Mpa Ic Physician 3015 W Palmetto St 506 E Cheves St, Ste 202 Moskos, Frank MD Florence, SC 29501 Florence, SC 29506-2616 Provider ID: 1587661 (843) 777-6870 (843) 777-2000 Gender: Male Fax: (843) 777-6871 Fax: (843) 777-7006 Mcleod Health Florence Mon - Fri 9:00 to 5:00 Languages: Tamil 555 E Cheves St PCMH: No Mon - Fri 9:00 to 5:00 Florence, SC 29506 PCMH: No (843) 777-2000 Mon - Sun 12:00 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 49 38642781

Specialty Physicians Florence Gastroenterology - cont. Oza, Veeral MD Spurling, Timothy MD Provider ID: 1153427 Provider ID: 1049364 Chowdhary, Deepak MD Gender: Male Gender: Male Provider ID: 772009 Mcleod Digestive Health Center 555 E Cheves St Gender: Male 401 E Cheves St, Ste 301 Florence, SC 29506-2617 Mcleod Digestive Helath Center Florence, SC 29506-2615 (843) 777-7333 401 E Cheves St, Ste 301 (843) 777-7166 PCMH: No Florence, SC 29506-2615 Fax: (843) 777-7167 (843) 777-7166 Languages: Gujarati, Hindi, Urdu Fax: (843) 777-7167 Wolford, John MD Mon - Thu 8:00 to 5:00 Provider ID: 775483 Mon - Fri 8:00 to 5:00 Fri 8:00 to 12:00 PCMH: No Gender: Male PCMH: No Mcleod Digestive Helath Center 401 E Cheves St, Ste 301 Jaggers, Terri MD Pannu, Davinderbir MD Florence, SC 29506-2615 Provider ID: 1605032 Provider ID: 1487128 (843) 777-7166 Gender: Female Gender: Male Fax: (843) 777-7167 Mcleod Digestive Health Center Mcleod Digestive Helath Center Mcleod Regional Medical Center 401 E Cheves St, Ste 301 401 E Cheves St, Ste 301 Mon - Fri 8:00 to 5:00 Florence, SC 29506-2615 Florence, SC 29506-2615 PCMH: No (843) 777-7166 (843) 777-7166 Fax: (843) 777-7167 Fax: (843) 777-7167 Zaraket, Vera MD Mon - Fri 8:00 to 5:00 Languages: Hindi, Punjabi PCMH: No Provider ID: 1849593 Mon - Thu 8:00 to 5:00 Gender: Female Fri 8:00 to 3:00 Musc Physicians Gastroenterology Moscatello, Salvatore DO PCMH: No Fl Provider ID: 1165304 805 Pamplico Hwy, Ste A220 Gender: Male Razick, Manver MD Florence, SC 29505 Mcleod Digestive Health Center Provider ID: 1019495 (843) 674-1530 401 E Cheves St, # 301 Gender: Male Fax: (843) 673-9098 Florence, SC 29506-2615 Musc Physicians Gastroenterology Musc Health Florence Medical (843) 777-7166 Fl Center Fax: (843) 777-7167 805 Pamplico Hwy, Ste A 220 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Florence, SC 29505-6056 PCMH: No PCMH: No (843) 674-1530 Fax: (843) 673-9098 General Surgery Moscatello, Salvatore DO Musc Health Florence Medical Provider ID: 1165304 Center Abdallah, Hatem MD Gender: Male Mon - Fri 8:00 to 5:00 Provider ID: 2354514 Mpa Ic Physicians PCMH: No Gender: Male 506 E Cheves St, Ste 202 Musc Physicians Floyd Medical Florence, SC 29506-2616 Spurling, Timothy MD Group (843) 777-7000 Provider ID: 1049364 805 Pamplico Hwy, Ste 230 Medical Fax: (843) 777-7006 Gender: Male Mall A Mon - Fri 9:00 to 5:00 Mcleod Digestive Health Center Florence, SC 29505 PCMH: No 401 E Cheves St, Ste 301 (843) 669-1220 Florence, SC 29506-2615 Fax: (843) 669-3725 (843) 777-7166 Mon - Fri 8:00 to 5:00 Fax: (843) 777-7167 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 50 38642781

Specialty Physicians Florence General Surgery - cont. Floyd, Cecil MD Harris, James MD Provider ID: 815416 Provider ID: 815482 Brewton, Cary DO Gender: Male Gender: Male Provider ID: 1157552 Musc Physicians Floyd Medical Musc Physicians Floyd Medical Gender: Male Group Group Pee Dee Surgical Group 805 Pamplico Hwy, A230 805 Pamplico Hwy, Ste A230 800 E Cheves St, Ste. 260 Florence, SC 29505 Florence, SC 29505-6047 Florence, SC 29506 (843) 669-1220 (843) 669-1220 (843) 319-1371 Fax: (843) 669-3725 Fax: (843) 669-3725 Fax: (843) 665-1257 Musc Health Florence Medical Musc Health Florence Medical Mon - Fri 8:00 to 5:00 Center Center PCMH: No Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Eck, Dustin MD Provider ID: 1970101 Gause, John MD Lee, Frank MD Gender: Male Provider ID: 776384 Provider ID: 817730 Mcleod Plastic And Reconstructive Gender: Male Gender: Male 401 E Cheves St, Ste 302 Pee Dee Surgical Group Musc Physicians Floyd Medical Florence, SC 29506-2615 800 E Cheves St, Ste 260 Group (843) 777-7255 Florence, SC 29506 805 Pamplico Hwy, Ste A230 Fax: (843) 679-6883 (843) 665-7941 Florence, SC 29505-5057 Mon - Fri 8:00 to 5:00 Fax: (843) 665-1257 (843) 674-5000 PCMH: No Mon - Fri 8:30 to 5:00 Fax: (843) 629-7274 PCMH: No Mon - Fri 8:00 to 5:00 Fam, Nabil MD PCMH: No Provider ID: 775157 Gause, John MD Gender: Male Provider ID: 776385 Mincey, Kenneth MD Fam Nabil A Gender: Male Provider ID: 775799 324 Mercy St Mcleod Regional Medical Center Gender: Male Lake City, SC 29560 555 E Cheves St Southern Surgical (843) 374-9945 Florence, SC 29506 901 E Cheves St Fax: (843) 374-5699 (843) 777-2000 Florence, SC 29506 Lake City Community Hospital Fax: (843) 777-5357 (843) 777-7010 Mon, Wed - Thu 2:00 to 5:00 Mon - Fri 9:00 to 5:00 Fax: (843) 777-7006 Tue, Fri 9:00 to 5:00 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Guidry, Christopher MD Fam, Nabil MD Provider ID: 2315836 Murrell, Amy MD Provider ID: 775157 Gender: Male Provider ID: 774287 Gender: Male Pee Dee Surgical Group Gender: Female 258 N Ron Mcnair Blvd 800 E Cheves St, Ste 260 Pee Dee Surgical Group Lake City, SC 29560-2462 Florence, SC 29506-2652 800 E Cheves St, Ste 260 (843) 374-2036 (843) 665-7941 Florence, SC 29502 Lake City Community Hospital Fax: (843) 665-1257 (843) 777-7900 PCMH: No Mon - Fri 8:00 to 5:00 Fax: (843) 665-1257 PCMH: No Mon - Fri 8:30 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 51 38642781

Specialty Physicians Florence General Surgery - cont. Richey, John MD Hand Surgery Provider ID: 1498820 Pack, Mark MD Gender: Male Litts, Christopher MD Provider ID: 899801 Pee Dee Surgical Group Provider ID: 1226038 Gender: Male 800 E Cheves St, Ste 260 Gender: Male Musc Physicians Floyd Medical Florence, SC 29506-2652 Mcleod Orthopaedics Group (843) 665-7941 800 E Cheves St, Ste 480 805 Pamplico Hwy, Ste A230 Fax: (843) 665-1257 Florence, SC 29506-2653 Florence, SC 29505-6057 Mon - Fri 8:00 to 5:00 (843) 777-7900 (843) 674-5000 PCMH: No Fax: (843) 777-7925 Fax: (843) 629-2611 Mon - Fri 8:00 to 5:00 Musc Health Florence Medical PCMH: No Center Sonfield, John MD Provider ID: 771990 Mon - Fri 8:00 to 5:00 Litts, Christopher MD PCMH: No Gender: Male Pee Dee Surgical Group Provider ID: 1226038 800 E Cheves St, Ste 260 Gender: Male Pearson, Joseph MD Florence, SC 29506 Mcleod Orthopaedics Florence Provider ID: 775283 (843) 665-7941 1005 E Cheves St Gender: Male Fax: (843) 665-1257 Florence, SC 29506-2707 Pee Dee Surgical Group Mon - Fri 8:30 to 5:00 (843) 777-7900 800 E Cheves St, Ste 260 PCMH: No Fax: (843) 777-7925 Florence, SC 29506 Mon - Fri 8:00 to 5:00 (843) 665-7941 PCMH: No Fax: (843) 665-1257 White, Nicholas MD Provider ID: 1240280 Mon - Fri 8:30 to 5:00 Moore, Robert MD PCMH: No Gender: Male Pee Dee Surgical Group Provider ID: 775563 800 E Cheves St, Ste 260 Gender: Male Player, Keith MD Florence, SC 29506 Hand Surgery Associates LLC Provider ID: 773708 (843) 665-7941 1498 Freedom Blvd, Ste 305 Gender: Male Fax: (843) 665-1257 Florence, SC 29505-6077 Pee Dee Surgical Group Mon - Fri 8:00 to 5:00 (843) 676-2720 800 E Cheves St, Ste 260 PCMH: No Fax: (843) 676-2722 Florence, SC 29506 Mon - Thu 8:00 to 4:30 (843) 665-7941 Fri 8:00 to 3:00 Fax: (843) 665-1257 Young, Eric MD PCMH: No Mon - Fri 9:00 to 5:00 Provider ID: 771079 PCMH: No Gender: Male Southern Surgical Hematology & Oncology 901 E Cheves St Bajaj, Rajesh MD Reynolds, Mark MD Florence, SC 29506 Provider ID: 774739 Provider ID: 777220 (843) 777-7010 Gender: Male Gender: Male Fax: (843) 777-7006 Pee Dee Surgical Group Mcleod Oncology And Hematology Mon - Fri 8:00 to 5:00 Asso 800 E Cheves St, Ste 260 PCMH: No Florence, SC 29506 401 E Cheves St, Ste 201 (843) 665-7941 Florence, SC 29506-2615 Fax: (843) 665-1257 (843) 777-7951 Mon - Fri 8:30 to 5:00 Fax: (843) 777-7981 PCMH: No Mon - Fri 8:30 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 52 38642781

Specialty Physicians Florence Hematology & Oncology - cont. Pavy, Michael MD Tazi, Karim MD Provider ID: 774006 Provider ID: 1001460 Dave, Sejal MD Gender: Male Gender: Male Provider ID: 2395283 Mcleod Oncology And Hematology Mcleod Oncology And Hematology Gender: Male Asso Asso Musc Physicians Hematology & 401 E Cheves St, Ste 201 401 E Cheves St, Ste 201 Oncolo Florence, SC 29506-2615 Florence, SC 29506-2615 805 Pamplico Hwy, Ste 315 Medical (843) 777-7951 (843) 777-7951 Mall A Fax: (843) 777-7981 Fax: (843) 777-7981 Florence, SC 29505 Mon - Fri 8:30 to 5:00 Mon - Fri 8:00 to 5:00 (843) 674-6460 PCMH: No PCMH: No Fax: (843) 674-6470 Mon - Fri 8:00 to 5:00 PCMH: No Pavy, Michael MD Infectious Disease Provider ID: 774007 Gender: Male Arroyo, Julio MD Huynh, Donny MD Carolina Health Care Provider ID: 1184882 Provider ID: 1477274 506 E Cheves St, Ste 202 Gender: Male Gender: Male Florence, SC 29506 360 N Irby St Mcleod Oncology And Hematology (843) 777-7951 Florence, SC 29501 Asso Fax: (843) 669-8609 (843) 667-9414 401 E Cheves St, Ste 201 Mon - Fri 9:00 to 5:00 Fax: (843) 667-1362 Florence, SC 29506-2615 PCMH: No Mon - Fri 7:30 to 5:00 (843) 777-7951 PCMH: No Fax: (843) 777-7981 Rao, Sreenivas MD Mon - Fri 8:00 to 5:00 Bharadwaj, Ramesh MD PCMH: No Provider ID: 776993 Gender: Male Provider ID: 773302 Mcleod Oncology And Hematology Gender: Male Lu, Rommel MD Asso Carolina Health Care Provider ID: 915799 401 E Cheves St, Ste 201 555 E Cheves St Gender: Male Florence, SC 29506-2615 Florence, SC 29506-2617 Mcleod Oncology And Hematology (843) 777-7951 (843) 777-5753 Asso Fax: (843) 777-7981 Fax: (843) 413-3197 401 E Cheves St, Ste 201 Mon - Fri 8:30 to 5:00 Languages: Hindi Florence, SC 29506 PCMH: No Mon - Fri 8:30 to 5:30 (843) 777-7951 PCMH: No Fax: (843) 777-7981 Languages: Tagalog Smith, James MD Bharadwaj, Ramesh MD Mon - Fri 8:00 to 5:00 Provider ID: 777217 Provider ID: 877531 PCMH: No Gender: Male Mcleod Oncology And Hematology Gender: Male Asso Hopehealth Motilal Nehru, Vijeyaluxmy MD 401 E Cheves St, Ste 201 360 N Irby St Florence, SC 29506 Florence, SC 29501-2808 Provider ID: 2318571 (843) 777-7951 (843) 667-9414 Gender: Female Fax: (843) 777-7981 Fax: (843) 667-4133 Mcleod Oncology Hematology Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Assoc PCMH: No PCMH: No 401 E Cheves St, Ste 201 Florence, SC 29506-2615 (843) 777-7951 Fax: (843) 777-7981 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 53 38642781

Specialty Physicians Florence Infectious Disease - cont. Bashour, Shadi DO Demarco, Paul MD Provider ID: 2006398 Provider ID: 774057 Chavez, Temujin MD Gender: Male Gender: Male Provider ID: 773941 Mcleod Nephrology Associates Mcleod Regional Medical Center Gender: Male 101 S Ravenel St, Ste 120 555 E Cheves St Carolinas Infectious Disease Florence, SC 29506-2619 Florence, SC 29506 805 Pamplico Hwy, Ste B125 (843) 777-7290 (843) 777-2000 Florence, SC 29505-6049 Fax: (843) 777-7280 Mon - Fri 9:00 to 5:00 (843) 674-6400 Mon - Thu 8:00 to 4:30 PCMH: No Fax: (843) 629-7274 Fri 8:00 to 12:00 Mon - Fri 8:30 to 5:30 PCMH: No PCMH: No Dozier, Samuel MD Provider ID: 770151 Blaker, Brian MD Gender: Male Chavez, Temujin MD Provider ID: 1991805 Cbo Mrmc Hospitalists Provider ID: 773941 Gender: Male 555 E Cheves St, Ste 377 Gender: Male Mcleod Cardiology Associates Florence, SC 29506-2617 555 E Cheves St 101 William H Johnson St, Ste 600 (843) 777-2000 Florence, SC 29506-2617 Florence, SC 29506-2773 Mon - Fri 9:00 to 5:00 (843) 674-6400 (843) 667-1891 PCMH: No PCMH: No Fax: (843) 665-2516 Mon - Fri 8:00 to 5:00 Govindappa, Venugopal MD Olatosi, Akinwale MD PCMH: No Provider ID: 877600 Provider ID: 1544723 Gender: Male Charyalu, Maddalithirumala MD Gender: Male Hopehealth Irby Govindappa LLC 360 N Irby St Provider ID: 2211862 121 E Cedar St Florence, SC 29501-2808 Gender: Male Florence, SC 29506 (843) 667-9414 Mcleod Regional Medical Center (843) 661-3499 Fax: (943) 667-1362 555 E Cheves St Fax: (843) 661-9438 Mon - Sat 8:00 to 8:00 Florence, SC 29506-2617 Languages: Hindi PCMH: No (843) 777-5246 Mon - Fri 9:00 to 5:00 Fax: (843) 777-5572 PCMH: No Internal Medicine Mon - Sun 12:00 to 12:00 PCMH: No Almeida, Nathan MD Huynh, Donny MD Provider ID: 774862 Provider ID: 1477274 Gender: Male Chavez, Temujin MD Gender: Male Pee Dee Cardiology Associates Provider ID: 773941 Mcleod Oncology And Hematology Loris Gender: Male Asso 101 William H Johnson St, Ste 600 555 E Cheves St 401 E Cheves St, Ste 201 Florence, SC 29506 Florence, SC 29506-2617 Florence, SC 29506-2615 (843) 667-1891 (843) 674-6400 (843) 777-7951 Fax: (643) 665-2516 PCMH: No Fax: (843) 777-7981 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No Chavez, Temujin MD PCMH: No Provider ID: 773941 Gender: Male Kamouh, Abdallah MD Carolinas Infectious Disease Provider ID: 1199060 805 Pamplico Hwy, Ste B125 Gender: Male Florence, SC 29505-6049 1594 Freedom Boulevard, Suite 100 (843) 674-6400 Florence, SC 29505 Fax: (843) 629-7274 (843) 674-4787 Mon - Fri 8:30 to 5:30 Musc Health Florence Medical PCMH: No Center PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 54 38642781

Specialty Physicians Florence Internal Medicine - cont. Okoh, Samuel MD Shah, Vipul MD Provider ID: 1223910 Provider ID: 767337 Karanam, Karthik MD Gender: Male Gender: Male Provider ID: 1218891 Peedee Nephrology Mcleod Regional Medical Center Gender: Male 1100 E Cheves St 555 E Cheves St Pee Dee Nephrology Florence, SC 29506 Florence, SC 29506 1100 E Cheves St (843) 669-6694 (843) 777-2000 Florence, SC 29506-2708 Fax: (843) 669-2500 Languages: Gujarati, Hindi (843) 669-6694 Musc Health Florence Medical Mon - Fri 9:00 to 5:00 Fax: (843) 669-2500 Center PCMH: No Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Singh, Harmohan MD Provider ID: 2201321 Kocherla, Cyrus MD Osaguona, Stephen MD Gender: Male Provider ID: 2312801 Provider ID: 1798184 Mcleod Regional Medical Center Gender: Male Gender: Male 555 E Cheves St Mcleod Cardiology Associates Mcleod Nephrology Assoc Florence, SC 29506-2617 101 William H Johnson St, Ste 600 101 S Ravenel St, Ste 120 (843) 777-5246 Florence, SC 29506-2773 Florence, SC 29506-2619 Fax: (843) 777-5572 (843) 667-1891 (843) 777-7290 Mon, Wed - Sun 12:00 to 12:00 Fax: (843) 665-2516 Fax: (843) 777-7260 Tue 1:20 to 12:00 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No Subnani, Kishore MD Maqsood, Farhan MD Patel, Supen MD Provider ID: 2160587 Provider ID: 1225609 Provider ID: 1816985 Gender: Male Gender: Male Gender: Male Mcleod Cardiology Associates Pee Dee Nephrology LLP Hopehealth Inc 101 William H Johnson St, Ste 600 1100 E Cheves St 600 E Palmetto St Florence, SC 29506-2773 Florence, SC 29506 Florence, SC 29506-2851 (843) 667-1891 (843) 669-6694 (843) 667-9414 Fax: (843) 665-2516 Fax: (843) 669-2500 Fax: (843) 667-1362 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Mon - Fri 7:30 to 5:00 PCMH: No PCMH: No PCMH: No Taype Perez De Roberts, Carmen Motilal Nehru, Vijeyaluxmy MD Pitiranggon, Pongstorn MD MD Provider ID: 1107656 Provider ID: 2318571 Provider ID: 1408594 Gender: Male Gender: Female Gender: Female Pee Dee Nephrology LLP Mcleod Oncology Hematology Mcleod Pulmonary Critical Care Ass 1100 E Cheves St 401 E Cheves St, Ste 202 Assoc Florence, SC 29506-2708 401 E Cheves St, Ste 201 Florence, SC 29506-2615 (843) 669-6694 (843) 777-7863 Florence, SC 29506-2615 Fax: (843) 679-4972 (843) 777-7951 Fax: (843) 777-7873 Mcleod Regional Medical Center Languages: Spanish Fax: (843) 777-7981 Musc Health Florence Medical Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Center PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 55 38642781

Specialty Physicians Florence Internal Medicine - cont. Wolery, James MD Cuff, Ryan MD Provider ID: 1841965 Provider ID: 1899349 Yarnal, James DO Gender: Male Gender: Male Provider ID: 777476 Advanced Cardiology Consultants Mcleod Maternal Fetal Medicine Gender: Male 258 N Ron Mcnair Blvd 101 William H Johnson St, Ste 270 Cbo Mrmc Hospitalists Lake City, SC 29560-2462 Florence, SC 29506-2763 555 E Cheves St (843) 629-8084 (843) 777-7753 Florence, SC 29506 Fax: (843) 629-8684 Fax: (843) 777-7754 (843) 777-5622 Mon - Fri 10:00 to 5:00 Mon - Fri 8:00 to 5:00 Mon - Fri 9:00 to 5:00 PCMH: No PCMH: No PCMH: No Wolery, James MD Finneran, Matthew MD Interventional Cardiology Provider ID: 1841965 Provider ID: 1959697 Blaker, Brian MD Gender: Male Gender: Male Provider ID: 1991805 Advanced Cardiology Consultants Mcleod Maternal Fetal Medicine Gender: Male P. 101 William H Johnson St, Ste 270 Mcleod Cardiology Associates 1706 2nd Loop Rd Florence, SC 29506-2763 101 William H Johnson St, Ste 600 Florence, SC 29501-6119 (843) 777-7753 Florence, SC 29506-2773 (843) 629-8084 Fax: (843) 777-7754 (843) 667-1891 Fax: (843) 629-8684 Mon - Fri 8:00 to 5:00 Fax: (843) 665-2516 Mon - Fri 10:00 to 5:00 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Goodier, Christopher MD Maternal Fetal Medicine Provider ID: 909252 Gender: Male Rowe, Llewellyn MD Alkis, Mallory MD Provider ID: 1841920 Mcleod Maternal Fetal Medicine Provider ID: 1992565 101 Johns St, Ste 270 Gender: Male Gender: Female Advanced Cardiology Consultants Florence, SC 29506-2769 Mcleod Maternal Fetal Medicine (843) 777-7753 P. 101 William H Johnson St, Ste 270 1706 2nd Loop Rd Fax: (843) 777-7754 Florence, SC 29506-2763 Mcleod Regional Medical Center Florence, SC 29501-6119 (843) 777-7753 (843) 629-8084 Mon - Fri 8:00 to 5:00 Fax: (843) 777-7754 PCMH: No Mon - Fri 10:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Johnson, Donna MD Provider ID: 776174 Rowe, Llewellyn MD Chang, Eugene MD Provider ID: 1841920 Gender: Female Provider ID: 772204 Mcleod Maternal Fetal Medicine Gender: Male Gender: Male Advanced Cardiology Consultants 101 Johns St, Ste 270 Mcleod Maternal Fetal Medicine Florence, SC 29506 258 N Ron Mcnair Blvd 101 Johns St, Ste 270 Lake City, SC 29560-2462 (843) 777-7753 Florence, SC 29506 Fax: (843) 777-7754 (843) 629-8084 (843) 777-7753 Fax: (843) 629-8684 Mon - Fri 8:00 to 5:00 Fax: (843) 777-7754 PCMH: No Mon - Fri 10:00 to 5:00 Mcleod Regional Medical Center PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 56 38642781

Specialty Physicians Florence Maternal Fetal Medicine - cont. Harlan, Joseph MD Alsaka, Mhd MD Provider ID: 771526 Provider ID: 1360852 Sullivan, Scott MD Gender: Male Gender: Male Provider ID: 772359 Pediatrix Medical Grp Of South Mcleod Regional Medical Center Gender: Female Caro 555 E Cheves St Mcleod Maternal Fetal Medicine 555 E Cheves St Florence, SC 29506-2617 101 Johns St, Ste 270 Florence, SC 29506 (843) 777-3717 Florence, SC 29506-2769 (843) 667-6229 Fax: (843) 777-5035 (843) 777-7753 Fax: (843) 667-1758 Mon - Sun 12:00 to 12:00 Fax: (843) 777-7754 Mon - Fri 8:00 to 4:30 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Govindappa, Venugopal MD Moeckel, Douglas MD Medical Oncology Provider ID: 900828 Provider ID: 1226030 Bajaj, Rajesh MD Gender: Male Gender: Male Provider ID: 777221 Pediatrix Medical Group Of South Pee Dee Nephrology LLP Gender: Male Ca 1100 E Cheves St Carolina Health Care 555 E Cheves St Florence, SC 29506-2708 401 East Cheves St, Ste 202 Florence, SC 29506-2617 (843) 669-6694 Florence, SC 29506 (843) 667-6229 Fax: (843) 669-2500 (843) 777-7951 Fax: (843) 667-1758 Mon - Fri 8:00 to 5:00 Fax: (843) 777-7981 Mon - Fri 8:00 to 8:00 PCMH: No PCMH: No PCMH: No Govindappa, Venugopal MD Smith, James MD Moeckel, Douglas MD Provider ID: 900828 Provider ID: 1544723 Provider ID: 777219 Gender: Male Gender: Male Gender: Male Pediatrix Medical Group Of South Govindappa LLC Carolina Health Care 121 E Cedar St 401 E Cheves St, Ste 201 Ca 805 Pamplico Hwy Florence, SC 29506 Florence, SC 29506-2616 (843) 661-3499 (843) 777-7951 Florence, SC 29505-6047 (843) 667-6229 Fax: (843) 661-9438 Fax: (843) 777-7981 Languages: Hindi Mon - Thu 8:30 to 5:30 Fax: (843) 667-1758 Mon - Fri 8:00 to 8:00 Mon - Fri 9:00 to 5:00 Fri 8:30 to 4:30 PCMH: No PCMH: No PCMH: No Nephrology Hempton, Brittany NP Neonatal Perinatal Medicine Provider ID: 1849556 Cox, Jesse MD Alsaka, Mhd MD Gender: Female Provider ID: 773064 Provider ID: 1148461 Musc Physicians Hematology & Gender: Male Gender: Male Oncolo Pediatrix Medical Group Of South Mcleod Nephrology Associates 805 Pamplico Hwy, Ste A315 Ca 101 S Ravenel St, Ste 120 Florence, SC 29505 555 E Cheves St Florence, SC 29506-2619 (843) 674-6460 Florence, SC 29506-2617 (843) 777-7290 Fax: (843) 674-6470 (843) 667-6229 Fax: (843) 777-7280 Musc Health Florence Medical Fax: (843) 667-1758 Languages: Arabic, French Center Mon - Fri 8:00 to 4:30 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 57 38642781

Specialty Physicians Florence Nephrology - cont. Regmi, Subash MD Aguilar, Maria MD Provider ID: 1360871 Provider ID: 2315534 Okoh, Samuel MD Gender: Male Gender: Female Provider ID: 1223910 Mcleod Regional Medical Center Mcleod Regional Medical Center Gender: Male 555 E Cheves St 555 E Cheves St Peedee Nephrology Florence, SC 29506-2617 Florence, SC 29506-2617 1100 E Cheves St (843) 777-3717 (843) 777-5246 Florence, SC 29506 Fax: (843) 777-5035 Fax: (843) 777-5572 (843) 669-6694 Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 Fax: (843) 669-2500 PCMH: No PCMH: No Musc Health Florence Medical Center Mon - Fri 8:00 to 5:00 Singh, Inderpal MD Amir, Murtaza MD PCMH: No Provider ID: 775701 Provider ID: 2315535 Gender: Male Gender: Male Pee Dee Nephrology LLP Mcleod Regional Medical Center Osaguona, Stephen MD 1100 E Cheves St 555 E Cheves St Provider ID: 1798184 Florence, SC 29506-2708 Florence, SC 29506-2617 Gender: Male (843) 669-6694 (843) 777-5246 Mcleod Nephrology Assoc Fax: (843) 669-2500 Fax: (843) 777-5572 101 S Ravenel St, Ste 120 Mon - Thu 10:00 to 5:00 Mon - Sun 12:00 to 12:00 Florence, SC 29506-2619 Fri 8:00 to 12:00 PCMH: No (843) 777-7290 PCMH: No Fax: (843) 777-7260 Mon - Fri 8:00 to 5:00 Avila, Amanda MD PCMH: No Neuro Psychiatrist Md Provider ID: 2315543 Gender: Female Smock, Alison MD Mcleod Regional Medical Center Pitiranggon, Pongstorn MD Provider ID: 1360848 555 E Cheves St Provider ID: 1107656 Gender: Female Florence, SC 29506-2617 Gender: Male Mcleod Regional Medical Center (843) 777-5246 Pee Dee Nephrology LLP 555 E Cheves St Fax: (843) 777-5572 1100 E Cheves St Florence, SC 29506-2617 Mon - Sun 12:00 to 12:00 Florence, SC 29506-2708 (843) 777-3717 PCMH: No (843) 669-6694 Fax: (843) 777-5035 Fax: (843) 679-4972 Mon - Sun 12:00 to 12:00 Mcleod Regional Medical Center PCMH: No Baluja, Vivek MD Musc Health Florence Medical Provider ID: 2315544 Gender: Male Center Neurology Mon - Fri 8:00 to 5:00 Mcleod Regional Medical Center PCMH: No Abalsom, Nicholas MD 555 E Cheves St Provider ID: 2315532 Florence, SC 29506-2617 Gender: Male (843) 777-5246 Pittard, John MD Fax: (843) 777-5572 Provider ID: 774041 Mcleod Regional Medical Center 555 E Cheves St Mon - Sun 12:00 to 12:00 Gender: Male PCMH: No 1100 E Cheves St Florence, SC 29506-2617 Florence, SC 29506-2708 (843) 777-5246 (843) 669-6694 Fax: (843) 777-5572 Behravan, Vahid MD Fax: (843) 669-2500 Mon - Sun 12:00 to 12:00 Provider ID: 2315546 PCMH: No PCMH: No Gender: Male Mcleod Regional Medical Center 555 E Cheves St Florence, SC 29506-2617 (843) 777-5246 Fax: (843) 777-5572 Mon - Sun 12:00 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 58 38642781

Specialty Physicians Florence Neurology - cont. Cheshire, Amanda MD Evans, Walter MD Provider ID: 2315560 Provider ID: 776498 Bixler, Christopher MD Gender: Female Gender: Male Provider ID: 2315552 Mcleod Regional Medical Center Comprehensive Neurological Gender: Male 555 E Cheves St Services Mcleod Regional Medical Center Florence, SC 29506-2617 436 W Palmetto St 555 E Cheves St (843) 777-5246 Florence, SC 29502 Florence, SC 29506-2617 Fax: (843) 777-5572 (843) 669-2007 (843) 777-5246 Mon - Sun 12:00 to 12:00 Fax: (843) 669-6677 Fax: (843) 777-5572 PCMH: No Mon - Thu 8:00 to 5:00 Mon - Sun 12:00 to 12:00 Fri 8:00 to 1:00 PCMH: No Chumble, Shubhangi MD PCMH: No Provider ID: 2315561 Borte, Bernadette MD Gender: Female Feliciano, Carlos MD Provider ID: 2315555 Mcleod Regional Medical Center Provider ID: 2315583 Gender: Female 555 E Cheves St Gender: Male Mcleod Regional Medical Center Florence, SC 29506-2617 Mcleod Regional Medical Center 555 E Cheves St (843) 777-5246 555 E Cheves St Florence, SC 29506-2617 Fax: (843) 777-5572 Florence, SC 29506-2617 (843) 777-5246 Mon - Sun 12:00 to 12:00 (843) 777-5246 Fax: (843) 777-5572 PCMH: No Fax: (843) 777-5572 Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 PCMH: No Colon-Garcia, Patricia MD PCMH: No Provider ID: 2315567 Boudreau, Michelle DO Gender: Female Figueroa Garcia, Alberto MD Provider ID: 2315557 Mcleod Regional Medical Center Gender: Female 555 E Cheves St Provider ID: 2315595 Mcleod Regional Medical Center Florence, SC 29506-2617 Gender: Male 555 E Cheves St (843) 777-5246 Mcleod Regional Medical Center Florence, SC 29506-2617 Fax: (843) 777-5572 555 E Cheves St (843) 777-5246 Mon - Sun 12:00 to 12:00 Florence, SC 29506-2617 Fax: (843) 777-5572 PCMH: No (843) 777-5246 Mon - Sun 12:00 to 12:00 Fax: (843) 777-5572 PCMH: No Corti, Sandro MD Mon - Sun 12:00 to 12:00 Provider ID: 2315569 PCMH: No Bradley, Nina DO Gender: Male Provider ID: 2315559 Mcleod Regional Medical Center Floyd, Jessica MD Gender: Female 555 E Cheves St Provider ID: 2315596 Mcleod Regional Medical Center Florence, SC 29506-2617 Gender: Female 555 E Cheves St (843) 777-5246 Mcleod Regional Medical Center Florence, SC 29506-2617 Fax: (843) 777-5572 555 E Cheves St (843) 777-5246 Mon - Sun 12:00 to 12:00 Florence, SC 29506-2617 Fax: (843) 777-5572 PCMH: No (843) 777-5246 Mon - Sun 12:00 to 12:00 Fax: (843) 777-5572 PCMH: No Dhadwal, Neetu MD Mon - Sun 12:00 to 12:00 Provider ID: 2315571 PCMH: No Gender: Female Mcleod Regional Medical Center 555 E Cheves St Florence, SC 29506-2617 (843) 777-5246 Fax: (843) 777-5572 Mon - Sun 12:00 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 59 38642781

Specialty Physicians Florence Neurology - cont. Heller, Adam MD Lamar, Cory MD Provider ID: 2315602 Provider ID: 2315604 Friedman, Mark DO Gender: Male Gender: Male Provider ID: 2315598 Mcleod Regional Medical Center Mcleod Regional Medical Center Gender: Male 555 E Cheves St 555 E Cheves St Mcleod Regional Medical Center Florence, SC 29506-2617 Florence, SC 29506-2617 555 E Cheves St (843) 777-5246 (843) 777-5246 Florence, SC 29506-2617 Fax: (843) 777-5572 Fax: (843) 777-5572 (843) 777-5246 Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 Fax: (843) 777-5572 PCMH: No PCMH: No Mon - Sun 12:00 to 12:00 PCMH: No Hodge, Michael MD Li, Mian MD Provider ID: 777478 Provider ID: 1360845 Good, Edward MD Gender: Male Gender: Male Provider ID: 769902 Mcleod Regional Medical Center Mcleod Regional Medical Center Gender: Male 555 E Cheves St 555 E Cheves St Mcleod Regional Medical Center Florence, SC 29506-2617 Florence, SC 29506-2617 555 E Cheves St (843) 777-2000 (843) 777-3717 Florence, SC 29506 Mon - Fri 9:00 to 5:00 Fax: (843) 777-5035 (843) 777-2000 PCMH: No Mon - Sun 12:00 to 12:00 Mon - Fri 9:00 to 5:00 PCMH: No PCMH: No Jimenez-Sanders, Rebecca MD Li, Sui MD Gupta, Raina MD Provider ID: 2315603 Provider ID: 2315614 Provider ID: 2315600 Gender: Female Gender: Male Gender: Female Mcleod Regional Medical Center Mcleod Regional Medical Center Mcleod Regional Medical Center 555 E Cheves St 555 E Cheves St 555 E Cheves St Florence, SC 29506-2617 Florence, SC 29506-2617 Florence, SC 29506-2617 (843) 777-5246 (843) 777-5246 (843) 777-5246 Fax: (843) 777-5572 Fax: (843) 777-5572 Fax: (843) 777-5572 Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 PCMH: No PCMH: No PCMH: No Kass, Robin MD Lue, Stanley MD Healy Jr, Robert MD Provider ID: 1832651 Provider ID: 2315615 Provider ID: 770976 Gender: Female Gender: Male Gender: Male Mcleod Regional Medical Center Mcleod Regional Medical Center R Joseph Healy Md Pa 555 E Cheves St 555 E Cheves St 805 Pamplico Hwy, Ste A130 Florence, SC 29506-2617 Florence, SC 29506-2617 Florence, SC 29505-6047 (843) 777-5240 (843) 777-5246 (843) 664-9200 Fax: (843) 777-5572 Fax: (843) 777-5572 Fax: (843) 664-9202 Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No Kirby, Deborah MD Masud, Muhammad MD Provider ID: 1425324 Provider ID: 2315616 Gender: Female Gender: Male Mcleod Neurological Associates Mcleod Regional Medical Center 800 E Cheves St, Ste 380 555 E Cheves St Florence, SC 29506-2649 Florence, SC 29506-2617 (843) 665-4104 (843) 777-5246 Fax: (843) 661-0160 Fax: (843) 777-5572 Mon - Fri 8:00 to 5:00 Mon - Sun 12:00 to 12:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 60 38642781

Specialty Physicians Florence Neurology - cont. Mojumder, Deb MD Patel, Neil MD Provider ID: 2315635 Provider ID: 2315645 Mcdonald, Mark MD Gender: Male Gender: Male Provider ID: 2315623 Mcleod Regional Medical Center Mcleod Regional Medical Center Gender: Male 555 E Cheves St 555 E Cheves St Mcleod Regional Medical Center Florence, SC 29506-2617 Florence, SC 29506-2617 555 E Cheves St (843) 777-5246 (843) 777-5246 Florence, SC 29506-2617 Fax: (843) 777-5572 Fax: (843) 777-5572 (843) 777-5246 Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 Fax: (843) 777-5572 PCMH: No PCMH: No Mon - Sun 12:00 to 12:00 PCMH: No Mowzoon, Nima MD Plancher, Joao Mc-Oneil MD Provider ID: 2315636 Mednick, Adam MD Gender: Male Provider ID: 2315653 Provider ID: 2315624 Mcleod Regional Medical Center Gender: Male Gender: Male 555 E Cheves St Mcleod Regional Medical Center Mcleod Regional Medical Center Florence, SC 29506-2617 555 E Cheves St 555 E Cheves St (843) 777-5246 Florence, SC 29506-2617 Florence, SC 29506-2617 Fax: (843) 777-5572 (843) 777-5246 (843) 777-5246 Mon - Sun 12:00 to 12:00 Fax: (843) 777-5572 Fax: (843) 777-5572 PCMH: No Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 PCMH: No PCMH: No Nagaraja, Harsha MD Provider ID: 2315643 Riordan, Katherine MD Mehari, Tigist MD Gender: Male Provider ID: 2315654 Provider ID: 2315625 Mcleod Regional Medical Center Gender: Female Gender: Female 555 E Cheves St Mcleod Regional Medical Center Mcleod Regional Medical Center Florence, SC 29506-2617 555 E Cheves St 555 E Cheves St (843) 777-5246 Florence, SC 29506-2617 Florence, SC 29506-2617 Fax: (843) 777-5572 (843) 777-5246 (843) 777-5246 Mon - Sun 12:00 to 12:00 Fax: (843) 777-5572 Fax: (843) 777-5572 PCMH: No Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 PCMH: No PCMH: No Owens, Elijah MD Provider ID: 901543 Saha, Sam MD Meyers, Clifford MD Gender: Male Provider ID: 2315663 Provider ID: 2315633 Musc Physicians Neurology Gender: Male Gender: Male Florence Mcleod Regional Medical Center Mcleod Regional Medical Center 1594 Freedom Blvd, Ste C305 555 E Cheves St 555 E Cheves St Florence, SC 29505-6046 Florence, SC 29506-2617 Florence, SC 29506-2617 (843) 669-0927 (843) 777-5246 (843) 777-5246 Fax: (843) 665-9323 Fax: (843) 777-5572 Fax: (843) 777-5572 Musc Health Florence Medical Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 Center PCMH: No PCMH: No Mon, Wed - Fri 8:00 to 5:00 Tue 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 61 38642781

Specialty Physicians Florence Neurology - cont. Snyder, Michael MD Won, Mai MD Provider ID: 2315675 Provider ID: 2315696 Sebesto, Jason DO Gender: Male Gender: Female Provider ID: 2315665 Mcleod Regional Medical Center Mcleod Regional Medical Center Gender: Male 555 E Cheves St 555 E Cheves St Mcleod Regional Medical Center Florence, SC 29506-2617 Florence, SC 29506-2617 555 E Cheves St (843) 777-5246 (843) 777-5246 Florence, SC 29506-2617 Fax: (843) 777-5572 Fax: (843) 777-5572 (843) 777-5246 Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 Fax: (843) 777-5572 PCMH: No PCMH: No Mon - Sun 12:00 to 12:00 PCMH: No Sombutmai, Chut DO Zaman, Mohammed DO Provider ID: 2315676 Provider ID: 2315703 Sevilis, Theresa DO Gender: Male Gender: Male Provider ID: 2315666 Mcleod Regional Medical Center Mcleod Regional Medical Center Gender: Female 555 E Cheves St 555 E Cheves St Mcleod Regional Medical Center Florence, SC 29506-2617 Florence, SC 29506-2617 555 E Cheves St (843) 777-5246 (843) 777-5246 Florence, SC 29506-2617 Fax: (843) 777-5572 Fax: (843) 777-5572 (843) 777-5246 Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 Fax: (843) 777-5572 PCMH: No PCMH: No Mon - Sun 12:00 to 12:00 PCMH: No Vajapey, Geetanjali MD Neuropsychology Provider ID: 2315691 Shissias, Charles MD Gender: Female Hagan, Timothy MD Provider ID: 2197533 Mcleod Regional Medical Center Provider ID: 1360842 Gender: Male 555 E Cheves St Gender: Male Mcleod Regional Medical Center Florence, SC 29506-2617 Mcleod Regional Medical Center 555 E Cheves St (843) 777-5246 555 E Cheves St, Ste 377 Florence, SC 29506-2617 Fax: (843) 777-5572 Florence, SC 29506-2617 (843) 777-5246 Mon - Sun 12:00 to 12:00 (843) 777-5753 Fax: (843) 777-5572 PCMH: No Fax: (843) 777-5035 Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 PCMH: No PCMH: No Valanta, Douglas MD Provider ID: 2315692 Skinner, Roland MD Gender: Male Neuroradiology Provider ID: 770624 Mcleod Regional Medical Center Gender: Male Edgar, Kenneth MD 555 E Cheves St Provider ID: 1086977 Mcleod Neurological Associates Florence, SC 29506-2617 800 E Cheves St, Ste 380 Gender: Male (843) 777-5246 Olanta Family Care Florence, SC 29506 Fax: (843) 777-5572 (843) 665-4104 211 S Jones Rd Mon - Sun 12:00 to 12:00 Olanta, SC 29114-9705 Fax: (843) 661-0160 PCMH: No Mon - Fri 8:00 to 5:00 (843) 396-9730 PCMH: No Fax: (843) 396-9735 Vidgop, Yelana MD Mon - Thu 8:00 to 5:00 Provider ID: 2315694 Fri 8:00 to 12:00 Gender: Female PCMH: No Mcleod Regional Medical Center 555 E Cheves St Florence, SC 29506-2617 (843) 777-5246 Fax: (843) 777-5572 Mon - Sun 12:00 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 62 38642781

Specialty Physicians Florence Neurosurgery Boyd, Louise MD Chaudhry, Anu MD Provider ID: 1840835 Provider ID: 774061 Dominique, Devanand MD Gender: Female Gender: Female Provider ID: 1697532 Musc Physicians Women's Health Florence Womens Health Gender: Male Flor 101 Johns St, Ste 360 Florence Neurosurgery And Spine 1590 Freedom Blvd, Ste B Florence, SC 29506 1204 E Cheves St Florence, SC 29505-6071 (843) 678-9994 Florence, SC 29506-2710 (843) 665-9581 Fax: (843) 679-5515 (843) 673-0122 Fax: (843) 431-2171 Languages: Hindi Mon - Thu 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Mon - Thu 8:00 to 4:00 Fri 8:00 to 2:00 PCMH: No PCMH: No PCMH: No Browning, John MD Coughlin, Eric MD Obstetrics/Gynecology Provider ID: 773871 Provider ID: 1464199 Alkis, Mallory MD Gender: Male Gender: Male Provider ID: 1992565 Mcleod OBGYN Associates Mcleod Women's Care Gender: Female 101 Johns St, Ste 500 101 William H. Johnson St, Ste 200 Mcleod Maternal Fetal Medicine Florence, SC 29506-2772 Florence, SC 29506-2776 101 William H Johnson St, Ste 270 (843) 777-7400 (843) 777-7500 Florence, SC 29506-2763 Fax: (843) 777-7440 Mon - Fri 8:00 to 5:00 (843) 777-7753 Mon - Fri 8:30 to 5:00 PCMH: No Fax: (843) 777-7754 PCMH: No Mon - Fri 8:00 to 5:00 Coughlin, Eric MD PCMH: No Browning, John MD Provider ID: 1464199 Provider ID: 773872 Gender: Male Mcleod Women's Care Baroody, Brent MD Gender: Male Mrmc Family Medicine Ctr OBGYN 101 William H. Johnson St, Ste 430 Provider ID: 1070547 Florence, SC 29506-2777 Gender: Male 555 E Cheves St Florence, SC 29501 (843) 777-7500 Brent Baroody Md Fax: (843) 777-7533 1523 Heritage Ln, Unit A (834) 777-2800 Fax: (843) 777-5350 Mon - Fri 8:00 to 5:00 Florence, SC 29505-3197 PCMH: No (843) 673-9992 Mon - Fri 9:00 to 5:00 Fax: (843) 673-9996 PCMH: No Mon - Thu 8:00 to 5:00 Cuff, Ryan MD Fri 8:00 to 12:00 Campbell, William MD Provider ID: 1899349 PCMH: No Provider ID: 776666 Gender: Male Gender: Male Mcleod Maternal Fetal Medicine Mcleod OBGYN Associates 101 William H Johnson St, Ste 270 Baroody, Brent MD Florence, SC 29506-2763 Provider ID: 773958 101 Johns St, Ste 500 Florence, SC 29506-2772 (843) 777-7753 Gender: Male Fax: (843) 777-7754 David R Chapman Md PC (843) 777-7400 Fax: (843) 777-7440 Mon - Fri 8:00 to 5:00 1523 Heritage Ln, Ste A PCMH: No Florence, SC 29505 Mon - Fri 9:00 to 5:00 (843) 673-9992 PCMH: No Fax: (843) 673-9996 Davidson, James MD Mon - Fri 9:00 to 5:00 Provider ID: 770985 PCMH: No Gender: Male Mcleod Women's Care 101 William H. Johnson St, Ste 200 Florence, SC 29506 (843) 777-7500 Fax: (843) 777-7533 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 63 38642781

Specialty Physicians Florence Obstetrics/Gynecology - cont. Goldstein, Lewis MD Hucks, Mark MD Provider ID: 773954 Provider ID: 776703 Davidson, James MD Gender: Male Gender: Male Provider ID: 770985 Goldstein Lewis W Advanced Womens Care Gender: Male 653 S Coit St 101 Johns St, Ste 200 Mcleod Women's Care Florence, SC 29501-5256 Florence, SC 29506 101 William H. Johnson St, Ste 430 (843) 317-6600 (843) 622-2299 Florence, SC 29506-2777 Fax: (843) 317-9259 Fax: (843) 656-2001 (843) 777-7500 Mon - Thu 8:30 to 5:00 Mon - Fri 9:00 to 5:00 Fax: (843) 777-7533 Fri 8:30 to 12:00 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Kolb, Cynthia MD Greenan, Candice MD Provider ID: 774288 Emerson, Gary MD Provider ID: 1487810 Gender: Female Provider ID: 775696 Gender: Female Mcleod OBGYN Associates Gender: Male Mcleod Ob/Gyn Associates 101 Johns St, Ste 300 Mcleod OBGYN Associates 101 Johns St, Ste 500 Florence, SC 29506-2772 101 Johns St, Ste 500 Florence, SC 29506-2782 (843) 777-7400 Florence, SC 29506-2772 (843) 777-7400 Fax: (843) 777-7440 (843) 669-1264 Fax: (843) 777-7440 Mon - Fri 9:00 to 5:00 Fax: (843) 665-6326 Mon - Thu 8:00 to 5:00 PCMH: No Mon - Fri 8:30 to 5:00 Fri 8:00 to 2:00 PCMH: No PCMH: No Kolb, Cynthia MD Provider ID: 774290 Emerson, Gary MD Head, Barbara MD Gender: Male Provider ID: 775697 Provider ID: 1435346 Mrmc Family Medicine Ctr OBGYN Gender: Male Gender: Female 555 E Cheves St Mrmc Family Medicine Ctr OBGYN Mcleod Maternal Fetal Medicine Florence, SC 29501 555 E Cheves St 101 Johns St, Ste 270 (834) 777-2800 Florence, SC 29501 Florence, SC 29506-2777 Fax: (843) 777-5350 (834) 777-2800 (843) 777-7753 Mon - Fri 9:00 to 5:00 Fax: (843) 777-5350 Fax: (843) 777-7754 PCMH: No Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Litts, Patricia MD Provider ID: 1239570 Finneran, Matthew MD Hemingway, Shauna MD Gender: Female Provider ID: 1959697 Provider ID: 1849553 Mcleod Women's Care Gender: Male Gender: Female 101 William H. Johnson St, Ste 200 Mcleod Maternal Fetal Medicine Musc Physicians Women's Health Florence, SC 29506 101 William H Johnson St, Ste 270 Flor (843) 777-7500 Florence, SC 29506-2763 1590 Freedom Blvd, Ste B Fax: (843) 777-7533 (843) 777-7753 Florence, SC 29505 Mon - Fri 8:00 to 5:00 Fax: (843) 777-7754 (843) 665-9581 PCMH: No Mon - Fri 8:00 to 5:00 Fax: (843) 669-6426 PCMH: No Musc Health Florence Medical Litts, Patricia MD Center Provider ID: 1239570 Mon - Fri 8:00 to 5:00 Gender: Female PCMH: No Mcleod Women's Care 101 William H. Johnson St, Ste 430 Florence, SC 29506-2777 (843) 777-7500 Fax: (843) 777-7533 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 64 38642781

Specialty Physicians Florence Obstetrics/Gynecology - cont. Suffrant, Germina MD Ophthalmology Provider ID: 902145 Lusk, Clifford MD Gender: Female Clark, William MD Provider ID: 773596 Musc Physicians Women's Health Provider ID: 773722 Gender: Male Flor Gender: Male Mcleod Women's Care 1590 Freedom Blvd, Ste B 400 N Cashua Dr 101 William H Johnson St, Ste 200 Florence, SC 29505-6071 Florence, SC 29501-2098 Florence, SC 29506-2769 (843) 665-9581 (803) 931-0077 (843) 777-7500 Fax: (843) 669-6426 Fax: (803) 931-0076 Fax: (843) 777-7533 Musc Health Florence Medical PCMH: No Mon - Fri 8:00 to 5:00 Center PCMH: No Mon - Fri 8:00 to 5:00 Goodson, James MD PCMH: No Provider ID: TPVGOOD32-02 Patchett, Jennifer MD Gender: Male Provider ID: 1571564 Tatum, Charles MD Stokes Regional Eye Centers Gender: Female Provider ID: 773952 367 West Evans Street Musc Physicians Women's Health Gender: Male Florence, SC 29501 Flor Mcleod OBGYN Associates (843) 669-4156 1590 Freedom Blvd, Ste B 101 Johns St, Ste 500 Fax: (843) 664-2122 Florence, SC 29505-6071 Florence, SC 29506-2772 Mon - Thu 8:00 to 5:30 (843) 674-1657 (843) 777-7400 Fri 8:00 to 12:00 Fax: (843) 669-6426 Fax: (843) 777-7440 PCMH: No Musc Health Florence Medical Mon - Fri 9:00 to 5:00 Center PCMH: No Greene, Howard MD Mon - Fri 8:00 to 5:00 Provider ID: 1899332 PCMH: No Tollison, Steven MD Gender: Male Provider ID: 2329388 Clemson Eye Pa D/B/Acarolinas Scott, Vincent MD Gender: Male Cent Provider ID: 1849586 Hopehealth Irby 400 N Cashua Dr Gender: Male 360 N Irby St Florence, SC 29501-2098 Musc Physicians Urogynecology Florence, SC 29501-2808 (843) 664-9393 Flore (843) 667-9414 Fax: (843) 664-2301 1594 Freedom Blvd, Ste C206 Fax: (843) 667-1362 Mon - Fri 8:00 to 5:00 Florence, SC 29505 Mon - Sat 8:00 to 8:00 PCMH: No (843) 413-6930 PCMH: No Fax: (843) 674-2457 Greene, Howard MD Musc Health Florence Medical Provider ID: 776606 Center Wineland, Rebecca MD Provider ID: 1629825 Gender: Male Mon - Fri 8:00 to 5:00 Carolinas Center For Sight PC PCMH: No Gender: Female Mcleod Maternal Fetal Medicine 400 N Cashua Dr 101 Johns St, Ste 270 Florence, SC 29501 Stonerock, Emily MD Florence, SC 29506-2777 (843) 664-9393 Provider ID: 897112 (843) 777-7753 Fax: (843) 664-2301 Gender: Female Fax: (843) 777-7754 Mcleod Regional Medical Center Musc Physicians Women's Health Mon - Fri 8:00 to 5:00 Languages: Spanish Flor PCMH: No Mon - Fri 8:00 to 5:00 1590 Freedom Blvd, Ste B PCMH: No Florence, SC 29505-6071 (843) 665-9581 Fax: (843) 669-6426 Musc Health Florence Medical Center Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 65 38642781

Specialty Physicians Florence Ophthalmology - cont. Lyttle, Deanna MD Seltzer, Samuel MD Provider ID: TPVLYTT01-01 Provider ID: 1899328 Hypes, Stephen DO Gender: Female Gender: Male Provider ID: 1876773 Stokes Regional Eye Centers Clemson Eye Pa Gender: Male 367 West Evans Street 400 N Cashua Dr Palmetto Retina Center Florence, SC 29501 Florence, SC 29501-2098 400 N Cashua Dr (843) 669-4156 (843) 664-9393 Florence, SC 29501-2098 Fax: (843) 664-2122 Fax: (843) 664-2301 (803) 931-0077 Mon - Thu 7:30 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (803) 360-8038 Fri 7:30 to 1:00 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Seltzer, Samuel MD Robinson, Joshua MD Provider ID: 770236 Johnson, David MD Provider ID: 1408589 Gender: Male Provider ID: 776010 Gender: Male Carolinas Center For Sight PC Gender: Male Palmetto Retina Center LLC 400 N Cashua Dr 400 N Cashua Dr 400 N Cashua Dr Florence, SC 29501-2098 Florence, SC 29501-2098 Florence, SC 29501 (843) 664-9393 (803) 931-0077 (803) 931-0077 Fax: (843) 664-2301 Fax: (803) 931-0076 Fax: (803) 360-8038 Mon - Fri 8:00 to 5:00 PCMH: No Thu 9:00 to 5:00 PCMH: No PCMH: No King, Gregory MD Stokes, Hunter MD Provider ID: 809157 Ross, Mark MD Provider ID: 808933 Gender: Male Provider ID: 809207 Gender: Male 367 W Evans St Gender: Male Stokes Regional Eye Centers Florence, SC 29501-3429 Stokes Regional Eye Centers 367 W Evans St (843) 669-4156 367 W Evans St Florence, SC 29501-3429 Fax: (843) 664-2122 Florence, SC 29501-3429 (843) 669-4156 PCMH: No (843) 669-4156 Fax: (843) 664-2122 Fax: (843) 664-2122 Mon - Thu 8:00 to 5:00 King, Gregory MD Mon - Thu 8:00 to 5:00 Fri 8:00 to 2:00 Provider ID: TPVKING14-03 Fri 8:00 to 2:00 PCMH: No Gender: Male PCMH: No Stokes Regional Eye Centers Stokes, Mark MD 367 West Evans Street Ross, Mark MD Provider ID: 808946 Florence, SC 29501 Provider ID: TPVROSS46-01 Gender: Male (843) 669-4156 Gender: Male Stokes Regional Eye Centers Fax: (843) 664-2122 Stokes Regional Eye Centers 367 W Evans St Mon - Thu 8:00 to 5:30 367 West Evans Street Florence, SC 29501-3429 Fri 8:00 to 12:00 Florence, SC 29501 (843) 669-4156 PCMH: No (843) 669-4156 Fax: (843) 664-2122 Fax: (843) 664-2122 Languages: Arabic Lyttle, Deanna MD Mon - Thu 7:30 to 5:00 Mon - Thu 8:00 to 5:00 Provider ID: 1258487 Fri 7:30 to 1:30 Fri 8:00 to 2:00 Gender: Female PCMH: No PCMH: No Stokes Regional Eye Center 367 W Evans St Florence, SC 29501-3429 (843) 669-4156 Fax: (843) 664-2122 Mon - Thu 8:00 to 5:00 Fri 8:00 to 2:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 66 38642781

Specialty Physicians Florence Ophthalmology - cont. Vasuki, Nagavivek MD Florence Primary Eyecare PC Provider ID: 1899330 Provider ID: TPVFLOR04-01 Stokes, Hunter MD Gender: Male 2014 South Irby Street Provider ID: TPVSTOK08-01 Clemson Eye Pa Florence, SC 29505 Gender: Male 400 N Cashua Dr (843) 679-9005 Stokes Regional Eye Centers Florence, SC 29501-2098 Fax: (843) 292-0403 367 West Evans Street (843) 664-9393 Mon - Thu 9:00 to 5:00 Florence, SC 29501 Fax: (843) 664-2301 Fri 9:00 to 4:00 (843) 669-4156 Mon - Fri 8:00 to 4:30 PCMH: No Fax: (843) 664-2122 PCMH: No Mon - Thu 7:30 to 5:00 Fri 7:30 to 1:30 Walmart Vision Center PCMH: No Whiteside, Daniela MD Provider ID: TPVWALM40-17 Provider ID: 1467833 2014 South Irby Street, Walmart Gender: Female Vision Center 2703 Stokes, Mark MD Five Star Diagnostic LLC Florence, SC 29505 Provider ID: TPVSTOK09-01 555 E Cheves St (843) 292-0401 Gender: Male Florence, SC 29506 Fax: (843) 292-0403 Stokes Regional Eye Centers (205) 538-3076 Mon - Fri 8:00 to 6:00 367 West Evans Street Fax: (205) 449-5031 Sat 9:00 to 6:00 Florence, SC 29501 Mon - Fri 8:00 to 5:00 PCMH: No (843) 669-4156 PCMH: No Fax: (843) 664-2122 Mon - Thu 7:30 to 5:00 Walmart Vision Center Fri 7:30 to 1:30 Zakhour, Isam MD Provider ID: TPVWALM40-58 PCMH: No Provider ID: 809199 900 Us 52 Highway, Walmart Vision Gender: Male Center 621 Stokes Regional Eye Centers Lake City, SC 29560 Vasuki, Nagavivek MD 367 W Evans St (843) 394-7626 Provider ID: 1192790 Florence, SC 29501-3429 Fax: (843) 394-8052 Gender: Male (843) 669-4156 Mon - Sat 9:00 to 6:00 Carolinas Centers For Sight Fax: (843) 664-2122 PCMH: No 400 N Cashua Dr Mon - Thu 8:00 to 5:00 Florence, SC 29501 Fri 8:00 to 2:00 Optometry (843) 664-9393 PCMH: No Fax: (843) 664-2301 Andrews, David OD Mcleod Regional Medical Center Optician Provider ID: TPVANDR14-01 Languages: Tamil Gender: Male Mon - Fri 8:00 to 4:30 Eyemart Express LLC Palmetto Vision Center PC PCMH: No Provider ID: TPVEYEM20-09 2138 West Palmetto Street, 2672 David H Mccleod Boulevard Palmetto Vision Center Vasuki, Nagavivek MD Florence, SC 29501 Florence, SC 29501 Provider ID: 1210236 (843) 407-3626 (843) 662-1989 Gender: Male Fax: (843) 665-1988 Fax: (843) 667-8897 Florence Surgery And Laser Center Mon - Fri 9:00 to 7:00 Mon - Fri 9:00 to 5:00 L Sat 9:00 to 5:00 PCMH: No 400 N Cashua Dr PCMH: No Florence, SC 29501 (843) 664-9393 Fax: (843) 664-2301 Languages: Tamil Mon - Fri 8:00 to 4:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 67 38642781

Specialty Physicians Florence Optometry - cont. Harvey, Shannon OD Lemon, Edward OD Provider ID: TPVHARV19-02 Provider ID: TPVLEMO02-08 Bergelt, Solita OD Gender: Female Gender: Male Provider ID: TPVBERG31-07 Stokes Regional Eye Centers Bergelt Optometric LLC Gender: Female 367 West Evans Street 900 Us 52 Highway Bergelt Optometric LLC Florence, SC 29501 Lake City, SC 29560 2672 David Mcleod Boulevard (843) 669-4156 (843) 394-1777 Florence, SC 29501 Fax: (843) 664-2122 Fax: (843) 432-3189 (843) 773-2758 Mon - Thu 8:00 to 5:00 Mon, Thu - Fri 9:00 to 4:00 Fax: (843) 432-3189 Fri 8:00 to 2:00 PCMH: No Mon - Thu 9:00 to 6:00 PCMH: No Fri 9:00 to 5:00 Sat 9:00 to 3:00 Patrick, Sean OD PCMH: No Hobbs, Steven OD Provider ID: TPVPATR12-01 Provider ID: TPVHOBB02-01 Gender: Male Gender: Male Clemson Eye Pa Brooks, Michelle OD Harrington Vision Center II 400 North Cashua Drive Provider ID: TPVBROO23-01 2151 West Evans Street, Suites G-H Florence, SC 29501 Gender: Female Florence, SC 29501 (864) 654-6706 Charles Wilfong Od (843) 669-2020 Fax: (864) 343-2074 181 West Cheves Street Fax: (843) 678-9200 Mon - Thu 8:00 to 5:30 Florence, SC 29501 Mon - Fri 9:00 to 5:30 Fri 8:30 to 5:00 (843) 662-0691 Sat 8:00 to 12:00 PCMH: No Fax: (843) 678-9723 PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No Russell, Samuel OD Hobbs, Steven OD Provider ID: TPVRUSS02-02 Provider ID: TPVHOBB02-02 Gender: Male Brooks, Michelle OD Gender: Male Samuel Russell Provider ID: TPVBROO23-02 Eyewear Boutique Inc 240 West Evans Street Gender: Female 339 West Main Street Florence, SC 29501 Bergelt Optometric LLC Lake City, SC 29560 (843) 662-3278 2672 David Mcleod Boulevard (843) 374-2040 Fax: (843) 667-6090 Florence, SC 29501 Fax: (843) 374-5131 Mon - Fri 8:30 to 5:30 (843) 773-2758 Mon - Thu 9:00 to 5:00 PCMH: No Fax: (843) 432-3189 Fri 9:00 to 12:00 Mon - Fri 9:00 to 5:00 PCMH: No Sat 9:00 to 3:00 Siegmund, Kelle OD PCMH: No Provider ID: TPVSIEG14-04 Lee, Jason OD Gender: Female Provider ID: TPVLEE57-01 Bergelt Optometric LLC Harvey, Shannon OD Gender: Male 900 Us 52 Highway Provider ID: 1641710 Palmetto Vision Center PC Lake City, SC 29560 Gender: Female 2138 West Palmetto Street, (843) 394-1774 Stokes Regional Eye Centers Palmetto Vision Center Fax: (843) 432-3189 367 W Evans St Florence, SC 29501 Mon, Thu - Fri 9:00 to 4:00 Florence, SC 29501-3429 (843) 662-1989 PCMH: No (843) 669-4156 Fax: (843) 667-8897 Fax: (843) 664-2121 www.palmettovisioncenter.com Mon - Thu 8:00 to 5:00 Mon - Fri 9:00 to 5:00 Fri 8:00 to 2:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 68 38642781

Specialty Physicians Florence Optometry - cont. Oral & Maxillofacial Surgery Chokshi, Rakesh MD Provider ID: 770203 Wallace, Robert OD Tagliareni, Jonathan DDS Gender: Male Provider ID: TPVWALL11-01 Provider ID: 2065941 Pee Dee Orthopaedic Associates Gender: Male Gender: Male 101 Johns St, Ste 100 Florence Primary Eyecare PC Mcleod Oral Maxillofacial Surgery Florence, SC 29506-2769 2014 South Irby Street, Florence 101 William H Johnson St, Ste 440 (843) 662-5233 Primary Eyecare Florence, SC 29506-2769 Fax: (843) 678-9003 Florence, SC 29505 (843) 667-6000 Mon - Fri 9:00 to 5:00 (843) 679-9005 Fax: (843) 667-6240 PCMH: No Fax: (843) 292-0403 Mon - Fri 8:00 to 5:00 Mon - Thu 9:00 to 5:00 PCMH: No Fri 9:00 to 4:00 Chokshi, Rakesh MD PCMH: No Provider ID: 770203 Orthopaedic Surgery Gender: Male Pee Dee Orthopaedic Associates Wallace, Christy OD Alan, Rodney MD Provider ID: 774060 1580 Freedom Blvd, Ste 1 Provider ID: TPVWALL14-01 Florence, SC 29505 Gender: Female Gender: Male Mcleod Orthopaedic Associates (843) 662-5233 Florence Primary Eyecare PC Fax: (843) 678-9003 2014 South Irby Street, Florence 800 E Cheves St, Ste 480 Florence, SC 29506-2653 Mon - Fri 9:00 to 5:00 Primary Eyecare PCMH: No Florence, SC 29505 (843) 777-7900 (843) 679-9005 Fax: (843) 777-7925 Fax: (843) 292-0403 Mon - Fri 8:00 to 5:00 Chokshi, Rakesh MD Mon - Thu 9:00 to 5:00 PCMH: No Provider ID: 770203 Fri 9:00 to 4:00 Gender: Male PCMH: No Alan, Rodney MD Mcleod Spine Center Provider ID: 774060 800 E Cheves St, Ste 480 B Florence, SC 29506-2653 Wilfong, Charles OD Gender: Male Mcleod Orthopaedics Florence (843) 432-1880 Provider ID: TPVWILF02-01 Fax: (843) 432-1022 Gender: Male 1005 E Cheves St Florence, SC 29506-2707 Mon - Fri 8:00 to 5:00 Harrington Vision Center PCMH: No 181 West Cheves Street (843) 777-7900 Florence, SC 29501 Fax: (843) 777-7925 (843) 662-0691 Mon - Fri 8:00 to 5:00 Denton, Patrick MD Fax: (843) 678-9723 PCMH: No Provider ID: 776321 Mon - Fri 9:00 to 5:00 Gender: Male PCMH: No Anglen, Jeffrey MD Mcleod Orthopaedics Florence Provider ID: 1501426 1005 E Cheves St Florence, SC 29506-2707 Zeplin, Vincent OD Gender: Male Mcleod Orthopaedics Florence (843) 662-5233 Provider ID: TPVZEPL01-19 Fax: (843) 432-1930 Gender: Male 1005 E Cheves St Florence, SC 29506-2707 Mon - Fri 8:00 to 5:00 Bergelt Optometric LLC PCMH: No 2672 David Mcleod Boulevard (843) 662-5233 Florence, SC 29501 Fax: (843) 777-7925 (843) 773-2758 Mon - Fri 8:00 to 5:00 Denton, Patrick MD Fax: (843) 432-3189 PCMH: No Provider ID: 776321 Mon - Tue, Thu 9:00 to 6:00 Gender: Male Fri 9:00 to 5:00 555 E Cheves St Sat 9:00 to 3:00 Florence, SC 29506-2617 PCMH: No (843) 777-2000 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 69 38642781

Specialty Physicians Florence Orthopaedic Surgery - cont. Edwards, Willie MD Mezzanotte, Thomas MD Provider ID: 770785 Provider ID: 774382 Deshmukh, Ashwin MD Gender: Male Gender: Male Provider ID: 1522563 555 E Cheves St Mcleod Orthopaedic Associates Gender: Male Florence, SC 29506-2617 800 E Cheves St, Ste 480 Mcleod Orthopaedic Associates (843) 777-2000 Florence, SC 29506-2653 800 E Cheves St, Ste 480 PCMH: No (843) 777-7900 Florence, SC 29506-2653 Fax: (843) 777-7925 (843) 777-7900 Feaker Jr, David DO Mon - Fri 8:00 to 5:00 Fax: (843) 777-7925 PCMH: No Languages: French, Spanish Provider ID: 1990157 Mon - Fri 8:00 to 5:00 Gender: Male PCMH: No Mcleod Orthopaedics Florence Mezzanotte, Thomas MD 1005 E Cheves St Provider ID: 774382 Florence, SC 29506-2707 Gender: Male Deshmukh, Ashwin MD (843) 777-7900 Mcleod Orthopaedics Florence Provider ID: 1522563 Fax: (843) 777-7925 1005 E Cheves St Gender: Male Mon - Thu 8:00 to 5:00 Florence, SC 29506-2707 Mcleod Orthopaedics Florence Fri 8:00 to 1:00 (843) 777-7900 1005 E Cheves St PCMH: No Fax: (843) 777-7925 Florence, SC 29506-2707 Mon - Fri 8:00 to 5:00 (843) 777-7900 PCMH: No Fax: (843) 777-7925 Gilpin, Albert MD Languages: French, Spanish Provider ID: 772765 Mon - Fri 8:00 to 5:00 Gender: Male Militano, Ulises MD PCMH: No Mcleod Pediatric Orthopaedics Provider ID: 1829367 800 E Cheves St, Ste 480 A Gender: Male Florence, SC 29506-2653 Mcleod Orthopaedics Florence Dipaolo, Zachary MD (843) 777-7337 1005 E Cheves St Provider ID: 2006505 Fax: (843) 777-7340 Florence, SC 29506-2707 Gender: Male Mon - Fri 8:00 to 5:00 (843) 777-7900 Mcleod Orthopaedics Florence PCMH: No Fax: (843) 777-7925 1005 E Cheves St Mon - Thu 8:00 to 5:00 Florence, SC 29506-2707 Litts, Christopher MD Fri 8:00 to 1:00 (843) 777-7900 PCMH: No Fax: (843) 777-7925 Provider ID: 1226038 Mon - Thu 8:00 to 5:00 Gender: Male Fri 8:00 to 1:00 Mcleod Orthopaedics O'dell, Jason MD PCMH: No 800 E Cheves St, Ste 480 Provider ID: 771124 Florence, SC 29506-2653 Gender: Male (843) 777-7900 Mcleod Orthopaedics Florence Edwards, Willie MD Fax: (843) 777-7925 1005 E Cheves St Provider ID: 770785 Mon - Fri 8:00 to 5:00 Florence, SC 29506-2707 Gender: Male PCMH: No (843) 662-5233 Mcleod Spine Center Fax: (843) 432-1930 800 E Cheves St, Ste 480 B Litts, Christopher MD Mon - Fri 8:00 to 5:00 Florence, SC 29506-2653 PCMH: No (843) 432-1880 Provider ID: 1226038 Fax: (843) 432-1022 Gender: Male Mon - Fri 8:00 to 5:00 Mcleod Orthopaedics Florence PCMH: No 1005 E Cheves St Florence, SC 29506-2707 (843) 777-7900 Fax: (843) 777-7925 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 70 38642781

Specialty Physicians Florence Orthopaedic Surgery - cont. Sparkman, Jeremy DO Wilson, Addison MD Provider ID: 2306069 Provider ID: 1829371 Palutsis, Gregory MD Gender: Male Gender: Male Provider ID: 1577699 Mcleod Orthopaedics Florence Mcleod Orthopaedics Florence Gender: Male 1005 E Cheves St 1005 E Cheves St Musc Physicians Orthopaedics Florence, SC 29506-2707 Florence, SC 29506-2707 Floren (843) 777-7900 (843) 777-7900 1580 Freedom Blvd, Ste 100 Fax: (843) 777-7925 Fax: (843) 777-7925 Florence, SC 29505-6074 Mon - Fri 8:00 to 5:00 Mon - Thu 8:00 to 5:00 (843) 413-6835 PCMH: No Fri 8:00 to 1:00 Fax: (843) 661-2194 PCMH: No Musc Health Florence Medical Center Thurman, Chad DO Mon - Fri 8:00 to 5:00 Provider ID: 1991908 Woodbury, David MD PCMH: No Gender: Male Provider ID: 844576 Mcleod Orthopaedics Florence Gender: Male 1005 E Cheves St Mcleod Orthopaedics Pugh, Kevin MD Florence, SC 29506-2707 800 E Cheves St, Ste 480 Provider ID: 2013085 (843) 777-7900 Florence, SC 29506-2653 Gender: Male Fax: (843) 777-7925 (843) 777-7900 Mcleod Orthopaedics Florence Mon - Thu 8:00 to 5:00 Fax: (843) 777-7925 1005 E Cheves St Fri 8:00 to 1:00 Mon - Fri 8:00 to 5:00 Florence, SC 29506-2707 PCMH: No PCMH: No (843) 777-7900 Fax: (843) 777-7925 Mon - Fri 8:00 to 5:00 Vanderhave, Kelly MD Woodbury, David MD PCMH: No Provider ID: 1798808 Provider ID: 844576 Gender: Female Gender: Male Mcleod Orthopaedics Florence Mcleod Orthopaedics Florence Refvem, William MD 1005 E Cheves St 1005 E Cheves St Provider ID: 1177470 Florence, SC 29506-2707 Florence, SC 29506-2707 Gender: Male (843) 777-7900 (843) 777-7900 Musc Physicians Orthopaedics Fax: (843) 777-7925 Fax: (843) 777-7925 Floren Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 1580 Freedom Blvd, Ste 100 PCMH: No PCMH: No Florence, SC 29505 (843) 413-6835 Fax: (843) 661-2194 Watt, Nigel MD Pain Management Provider ID: 771993 Musc Health Florence Medical Johnson, Bruce MD Center Gender: Male Mcleod Orthopaedics Florence Provider ID: 2028479 Mon - Fri 8:00 to 5:00 Gender: Male PCMH: No 1005 E Cheves St Florence, SC 29506-2707 Mcleod Spine Center (843) 662-5233 800 E Cheves St, Ste 480-B Riverarosado, Emanuel MD Fax: (843) 432-1930 Florence, SC 29506-2650 Provider ID: 2090134 Mon - Fri 8:00 to 5:00 (843) 432-1880 Gender: Male PCMH: No Fax: (843) 432-1022 Musc Physicians Orthopaedics Mon - Thu 8:00 to 5:00 Floren Fri 8:00 to 1:00 805 Pamplico Hwy PCMH: No Florence, SC 29505-6047 (843) 413-6835 Fax: (843) 661-2194 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 71 38642781

Specialty Physicians Florence Pediatric Cardiology Physical Medicine & Rehabilitation Plastic & Reconstructive Surgery Trant, Charles MD Alexander, Anthony MD Conner, Gerald MD Provider ID: 774735 Provider ID: 772633 Provider ID: 772613 Gender: Male Gender: Male Gender: Male Mcleod Pediatric Subspecialists Mcleod Spine Center Mcleod Plastic And Reconstructive 101 Johns St, Ste 400 800 E Cheves St, Ste 480 B 101 Johns St, Ste 500 Florence, SC 29506 Florence, SC 29506-2653 Florence, SC 29506 (843) 777-7300 (843) 432-1880 (843) 777-7010 Fax: (843) 777-7311 Fax: (843) 432-1022 Mon - Fri 9:00 to 5:00 Mcleod Regional Medical Center Mon - Fri 8:00 to 5:00 PCMH: No Mon - Thu 8:00 to 5:30 PCMH: No Fri 8:00 to 12:00 Conner, Gerald MD PCMH: No Chernev, Ivan MD Provider ID: 772613 Provider ID: 1185327 Gender: Male Pediatric Endocrinology Gender: Male Mcleod Plastic And Reconstructive Musc Physicians Physical Medicine 401 E Cheves St Tyson, Deidre MD 1925 Hoffmeyer Rd Florence, SC 29506-2615 Provider ID: 2160801 Florence, SC 29501-4011 (843) 777-7255 Gender: Female (843) 679-4214 Fax: (843) 679-6883 Mcleod Pediatric Subspecialists Fax: (843) 679-4217 Mon - Fri 9:00 to 5:00 101 William H Johnson St, Ste 400 Musc Health Florence Medical PCMH: No Florence, SC 29506-2769 Center (843) 777-5701 Mon - Fri 8:00 to 5:00 Eck, Dustin MD Fax: (843) 777-7320 PCMH: No Mon - Fri 8:00 to 5:00 Provider ID: 1970101 PCMH: No Gender: Male Coates-Wynn, Geoffrey MD Mcleod Plastic And Reconstructive Provider ID: 1174505 401 E Cheves St, Ste 302 Pediatrics Gender: Male Florence, SC 29506-2615 Hartzog, Timothy MD Musc Physicians Physical Medicine (843) 777-7255 Provider ID: 1710525 & Fax: (843) 679-6883 Gender: Male 1925 Hoffmeyer Rd Mon - Fri 8:00 to 5:00 Pediatrix Medical Group Of South Florence, SC 29501 PCMH: No Ca (843) 679-4214 555 East Cheves St Fax: (843) 679-4217 Podiatry Florence, SC 29506 Mon - Fri 8:00 to 5:00 (843) 661-6215 PCMH: No Baker, Jordanna DPM Fax: (855) 527-5510 Provider ID: 1352346 Mon - Sun 12:00 to 12:00 Lorenz, William MD Gender: Female PCMH: No Provider ID: 772486 Palmetto State Surgical Podiatry As Gender: Male 230 Cherokee Rd Florence, SC 29501 Tyson, Deidre MD Florence Rehabilitation Medicine 900 E Cheves St (843) 790-3338 Provider ID: 2160801 Fax: (843) 731-9384 Gender: Female Florence, SC 29506 (843) 661-4390 Mon - Tue, Thu 8:00 to 5:00 Mcleod Pediatric Subspecialists Wed 8:00 to 7:00 101 William H Johnson St, Ste 400 Fax: (843) 629-7485 Mon - Fri 8:00 to 5:00 Fri 8:00 to 1:00 Florence, SC 29506-2769 PCMH: No (843) 777-5701 PCMH: No Fax: (843) 777-7320 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 72 38642781

Specialty Physicians Florence Podiatry - cont. Lee, Misty DPM Psychiatry Provider ID: 1366373 Butterworth, Michelle DPM Gender: Female Bauer, Robert MD Provider ID: 771536 Palmetto State Surgical Podiatry As Provider ID: 1963100 Gender: Female 230 Cherokee Rd Gender: Male Pee Dee Foot Center Florence, SC 29501 360 N Irby St 258 N Ron Mcnair Blvd (843) 790-3338 Florence, SC 29501-2808 Lake City, SC 29560 Fax: (843) 731-9384 (843) 667-9414 (843) 355-9690 Mon - Fri 8:30 to 5:00 Fax: (843) 667-1362 Fax: (843) 355-9777 PCMH: No Languages: Spanish Mon, Thu 10:00 to 12:00 Mon - Fri 8:00 to 5:00 Tue 10:00 to 5:00 PCMH: No Wed 3:00 to 5:00 Mccann, Michael DPM Provider ID: 2354528 Fri 9:00 to 5:00 Bauer, Robert MD PCMH: No Gender: Male Musc Physicians Podiatry Florence Provider ID: 1963100 M Gender: Male Deblasi, Lori DPM 805 Pamplico Hwy Hopehealth Inc Provider ID: 1106158 Florence, SC 29505 600 E Palmetto St Gender: Female (843) 674-1480 Florence, SC 29506-2851 Musc Physicians Podiatry Florence Fax: (843) 674-6411 (843) 667-9414 805 Pamplico Hwy, Ste A320 Mon - Fri 8:00 to 5:00 Fax: (843) 667-1362 Florence, SC 29505 PCMH: No Languages: Spanish (843) 674-1480 Mon - Fri 7:30 to 5:00 Fax: (843) 674-6411 PCMH: No Musc Health Florence Medical Tyree, Christopher DPM Provider ID: 1727439 Center Modi, Nikunjkumar MD Mon - Thu 8:00 to 5:00 Gender: Male Physicians Footcare LLC Provider ID: 1184881 Fri 8:00 to 1:00 Gender: Male PCMH: No 709 W Evans St Florence, SC 29501-3411 Hope Health Inc (843) 665-4567 600 E Palmetto St Fink, Jessica DPM Mon - Thu 8:00 to 5:00 Florence, SC 29506 Provider ID: 2164719 Fri 8:00 to 1:00 (843) 667-9414 Gender: Female PCMH: No Fax: (843) 667-4133 Physicians Footcare Mon - Fri 7:30 to 5:00 709 W Evans St PCMH: No Florence, SC 29501-3411 Preventive Medicine (843) 665-4567 Leisy, Heather MD Reusche, Christian MD Mon - Thu 8:00 to 5:00 Provider ID: 1966106 Provider ID: 1360847 Fri 8:00 to 1:00 Gender: Female Gender: Male PCMH: No Hopehealth Irby Mcleod Regional Medical Center 360 N Irby St 555 E Cheves St Haire, Aaron DPM Florence, SC 29501-2808 Florence, SC 29506-2617 Provider ID: 1294123 (843) 667-9414 (843) 777-3717 Gender: Male Fax: (843) 667-1362 Fax: (843) 777-5035 Physicians Footcare Languages: French, Gujarati, Spanish Mon - Sun 12:00 to 12:00 709 W Evans St Mon - Sat 8:00 to 8:00 PCMH: No Florence, SC 29501-3411 PCMH: No (843) 665-4567 Fax: (843) 665-4448 Mon - Thu 8:00 to 5:00 Fri 8:00 to 1:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 73 38642781

Specialty Physicians Florence Psychiatry - cont. Anderson, Jason PSYD Jackel, Lisa PHD Provider ID: 1037190 Provider ID: 1240277 Shissias, Charles MD Gender: Male Gender: Female Provider ID: 2197533 Wellspring Psychology Group Pee Dee Professional Psychological Gender: Male 1340 Celebration Blvd, Unit A 514 W Palmetto St Mcleod Regional Medical Center Florence, SC 29501-5585 Florence, SC 29501 555 E Cheves St (843) 536-1180 (843) 319-2310 Florence, SC 29506-2617 Fax: (843) 536-1116 Fax: (855) 328-1383 (843) 777-5246 Mon - Tue 8:00 to 7:00 Mon - Fri 9:00 to 6:00 Fax: (843) 777-5572 Wed - Thu 8:00 to 5:00 PCMH: No Mon - Sun 12:00 to 12:00 PCMH: No PCMH: No Pritchard-Boone, Andrea PHD Hughes, Farrah PHD Psychology Provider ID: 1557319 Provider ID: 933784 Adams, Leah PSYD Gender: Female Gender: Female Provider ID: 1768073 Hopehealth Inc Seasona Psychology Associates LLC Gender: Female 360 N Irby St 314 S Mcqueen St Wellspring Psychology Group Florence, SC 29501-2808 Florence, SC 29501-4723 1340 Celebration Blvd (843) 667-9414 (843) 407-4440 Florence, SC 29501 Fax: (843) 667-1362 Fax: (843) 407-4461 (843) 536-1180 Mon - Fri 8:00 to 5:00 Mon 9:00 to 7:30 Fax: (843) 536-1116 PCMH: No Tue - Thu 8:00 to 7:30 Mon 9:00 to 7:00 Fri 8:30 to 2:00 Tue - Thu 8:00 to 7:00 Hughes, Farrah PHD PCMH: No Fri 8:00 to 5:00 Provider ID: 1557319 PCMH: No Gender: Female Sanders, Alexis PHD Hopehealth Inc Provider ID: 1241999 Adams, Carol CP 600 E Palmetto St Gender: Female Provider ID: 2232041 Florence, SC 29506 Seasons Psychology Associates LLC Gender: Female (843) 667-9414 314 S Mcqueen St Stewart Behavioral Health Fax: (843) 667-1362 Florence, SC 29501 525 S Dargan St Mon - Fri 7:30 to 5:00 (843) 407-4440 Florence, SC 29506-2549 PCMH: No Fax: (843) 407-4461 (843) 407-5419 Mon - Fri 9:00 to 5:00 Mon - Fri 9:00 to 7:00 Hunter, William PSYD PCMH: No PCMH: No Provider ID: 1816278 Gender: Male Sanders, Alexis PHD Allen, Dan PHD Hopehealth Irby Provider ID: 1985068 Provider ID: 1568831 360 N Irby St Gender: Female Gender: Male Florence, SC 29501-2808 Bask Psychological Services LLC Hopehealth Inc (843) 667-9414 2231 W Palmetto St, Ste 201 600 E Palmetto St Fax: (843) 667-1362 Florence, SC 29501-4079 Florence, SC 29506 Languages: Gujarati, Hindi, Spanish (843) 621-0263 (843) 667-9414 Mon - Sat 8:00 to 8:00 Fax: (843) 536-8522 PCMH: No Mon, Wed 8:00 to 1:00 Fax: (843) 667-1362 Tue, Thu 8:00 to 6:00 Mon - Fri 7:30 to 5:00 Fri 8:00 to 12:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 74 38642781

Specialty Physicians Florence Psychology - cont. Chamberlain, Brooke NP Jona, Vinod MD Provider ID: 1849539 Provider ID: 770926 Scearce, Edward PSYD Gender: Female Gender: Male Provider ID: 1030550 Musc Physicians Pulmonary Carolina Health Care Gender: Male Florence 555 E Cheves St Wellspring Psychology Group 805 Pamplico Hwy, Ste B300 Florence, SC 29506-2617 1340 Celebration Blvd, Unit A Florence, SC 29505 (843) 777-2000 Florence, SC 29501-5585 (843) 673-7529 Fax: (843) 413-3193 (843) 536-1180 Fax: (843) 673-7632 Languages: Hindi Fax: (843) 536-1116 Musc Health Florence Medical Mon - Fri 9:00 to 5:00 Mon - Tue 8:00 to 7:00 Center PCMH: No Wed - Thu 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Jona, Vinod MD Provider ID: 770927 Steele, Patrick CP Elya, Marwan MD Gender: Male Provider ID: 1786089 Provider ID: 770756 Pee Dee Cardiology Associates Gender: Male Gender: Female 101 Johns St, Ste 600 Stewart Behavioral Health Carolina Healthcare Florence, SC 29506 2704 S Irby St 555 E Cheves St (843) 667-1891 Florence, SC 29505-3434 Florence, SC 29506-2617 Fax: (843) 665-2516 (843) 407-5419 (843) 777-5622 Mon - Fri 8:00 to 5:00 Fax: (843) 407-7274 Fax: (843) 413-3197 PCMH: No Tue 8:30 to 5:30 Languages: French Wed 8:30 to 5:00 Mon - Fri 8:30 to 5:30 Seif, Fadi MD Thu - Fri 8:00 to 7:00 PCMH: No PCMH: No Provider ID: 896821 Gender: Male Hazelwood, William MD Musc Physicians Pulmonary Pulmonary Disease Provider ID: 770455 Florence Al Hourany, Ramzy MD Gender: Male 805 Pamplico Hwy, B300 Provider ID: 812744 Cbo Mrmc Hospitalists Florence, SC 29505 Gender: Male 555 E Cheves St, Ste 377 (843) 673-7529 Musc Physicians Pulmonary Florence, SC 29506-2617 Fax: (843) 673-7532 Florence (843) 777-2000 Musc Health Florence Medical 805 Pamplico Hwy, Ste B300 Mon - Fri 9:00 to 5:00 Center Florence, SC 29505-6081 PCMH: No Mon - Fri 8:00 to 5:00 (843) 673-7529 PCMH: No Fax: (843) 673-7532 Jona, Vinod MD Musc Health Florence Medical Provider ID: 770925 Zebian, Rami MD Center Gender: Male Provider ID: 896824 Mon - Fri 8:00 to 5:00 Mcleod Pulmonary And Critical Gender: Male PCMH: No Care Musc Physicians Pulmonary 401 E Cheves St, Ste 202 Florence Florence, SC 29506 805 Pamplico Hwy, Ste B 300 (843) 777-7863 Florence, SC 29505-6047 Fax: (843) 777-7873 (843) 673-7529 Languages: Hindi Fax: (843) 673-7532 Mon - Fri 8:30 to 5:30 Musc Health Florence Medical PCMH: No Center Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 75 38642781

Specialty Physicians Florence Pulmonary Disease - cont. Spencer, Thomas MD Senseney, Anna MD Provider ID: 773278 Provider ID: 1500954 Zein, Mohamad MD Gender: Male Gender: Female Provider ID: 1170778 T Rhett Spencer Md Pa Mcleod Primary Care Associates Gender: Male 805 Pamplico Hwy 800 E Cheves St, Ste 200 Musc Physicians Pulmonary Florence, SC 29505 Florence, SC 29506-2651 Florence (843) 674-2470 (843) 662-1502 805 Pamplico Hwy, Ste B300 Fax: (843) 674-2479 Fax: (843) 678-3611 Florence, SC 29505-6081 Mon - Fri 8:00 to 5:00 Mon - Thu 8:00 to 5:00 (843) 673-7529 PCMH: No Fri 8:00 to 12:00 Fax: (843) 673-7532 PCMH: No Musc Health Florence Medical Center Wooten, Charles MD Mon - Fri 8:00 to 5:00 Provider ID: 1849591 Turner, Robert MD PCMH: No Gender: Male Provider ID: 776362 Musc Physicians Radiation Gender: Male Oncology Carolina Health Care Radiation Oncology 805 Pamplico Hwy, Ste A315 506 E Cheves St, Ste 202 Clyburn-Ipock, Virginia MD Florence, SC 29505-6056 Florence, SC 29506 Provider ID: 1054097 (843) 674-6460 (843) 777-7000 Gender: Female Fax: (843) 674-2519 Fax: (843) 413-3199 401 East Cheves Street Musc Health Florence Medical Mon - Fri 8:30 to 5:30 Florence, SC 29506 Center PCMH: No (843) 777-2014 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Turner III, Robert MD Provider ID: 1713219 Grubb, Larry MD Rheumatology Gender: Male Hopehealth Inc Provider ID: 769942 Docherty Jr, Jon MD Gender: Male 600 E Palmetto St Provider ID: 1968960 Florence, SC 29506-2851 T Rhett Spencer Md Pa Gender: Male 555 E Cheves St (843) 667-9414 Hopehealth Inc Fax: (843) 667-1362 Florence, SC 29506 600 E Palmetto St (843) 777-2014 Mon - Fri 8:00 to 5:00 Florence, SC 29506-2851 PCMH: No Fax: (843) 777-2019 (843) 667-9414 Mon - Fri 8:00 to 5:00 Fax: (843) 667-1362 PCMH: No Mon - Fri 7:30 to 5:00 Turner III, Robert MD PCMH: No Provider ID: 1713219 Spencer, Thomas MD Gender: Male Hopehealth Irby Provider ID: 773278 Keenan, Robert MD Gender: Male 360 N Irby St Provider ID: 2360059 Florence, SC 29501-2808 T Rhett Spencer Md Pa Gender: Male 555 E Cheves St (843) 667-9414 Articularis Healthcare Group Inc. Fax: (843) 667-1362 Florence, SC 29506 800 E Cheves St, Ste 280 (843) 777-2015 Mon - Fri 8:00 to 8:00 Florence, SC 29506-2652 PCMH: No Fax: (843) 777-2019 (843) 973-8770 Mon - Fri 8:00 to 5:00 Fax: (843) 428-2490 PCMH: No Mon - Thu 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 76 38642781

Specialty Physicians Florence Sports Medicine Runyan, Chadley MD Woodbury, David MD Provider ID: 1692337 Provider ID: 844576 Denton, Patrick MD Gender: Male Gender: Male Provider ID: 776321 Florence Neurosurgery And Spine Mcleod Orthopaedics Florence Gender: Male 1204 E Cheves St 1005 E Cheves St Mcleod Orthopaedics Florence Florence, SC 29506-2710 Florence, SC 29506-2707 1005 E Cheves St (843) 673-0122 (843) 777-7900 Florence, SC 29506-2707 Mon - Thu 8:00 to 5:00 Fax: (843) 777-7925 (843) 662-5233 Fri 8:00 to 2:00 Mon - Fri 8:00 to 5:00 Fax: (843) 432-1930 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Runyan, Chadley MD Thoracic & Cardiovascular Surgery Provider ID: 1692337 Denton, Patrick MD Gender: Male Cunningham, Christopher MD Provider ID: 776321 Florence Neurosurgery And Spine Gender: Male 555 E Cheves St Provider ID: 773957 555 E Cheves St Florence, SC 29506-2617 Gender: Male Florence, SC 29506-2617 (843) 292-0600 Mcleod Vascular Associates (843) 777-2000 Fax: (843) 292-8444 101 S Ravenel St, Ste 230 PCMH: No Mon - Thu 8:00 to 5:00 Florence, SC 29506-2624 Fri 8:00 to 2:00 (803) 777-7043 PCMH: No Fax: (803) 777-7041 Dipaolo, Zachary MD Mon - Fri 8:00 to 5:00 Provider ID: 2006505 PCMH: No Gender: Male Runyan, Chadley MD Mcleod Orthopaedics Florence Provider ID: 776083 1005 E Cheves St Gender: Male Jones, Gregory MD Florence, SC 29506-2707 Mcleod Orthopaedics Florence Provider ID: 1210237 (843) 777-7900 1005 E Cheves St Gender: Male Fax: (843) 777-7925 Florence, SC 29506-2707 Musc Physicians Cardiovascular Mon - Thu 8:00 to 5:00 (843) 777-7900 Surg Fri 8:00 to 1:00 Fax: (843) 432-1930 805 Pamplico Hwy, Ste B-300 PCMH: No Mon - Fri 8:00 to 5:00 Florence, SC 29505 PCMH: No (843) 676-2760 Fax: (843) 676-2762 Runyan, Chadley MD Musc Health Florence Medical Provider ID: 1692337 Woodbury, David MD Center Gender: Male Provider ID: 844576 Mon - Fri 8:00 to 5:00 Florence Neurosurgery And Spine Gender: Male PCMH: No 805 Pamplico Hwy Mcleod Orthopaedics Florence, SC 29505-6047 800 E Cheves St, Ste 480 (843) 292-0600 Florence, SC 29506-2653 Sims, David MD Fax: (843) 292-8444 (843) 777-7900 Provider ID: 2041701 Mon - Thu 8:00 to 5:00 Fax: (843) 777-7925 Gender: Male Fri 8:00 to 2:00 Mon - Fri 8:00 to 5:00 Mcleod Cardiothoracic Surgical PCMH: No PCMH: No Asso 101 S Ravenel St, Ste 270 Florence, SC 29506-2624 (843) 777-7020 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 77 38642781

Specialty Physicians Florence Thoracic & Cardiovascular Surgery - Messier Jr, Robert MD Choi, Gwen MD cont. Provider ID: 1501424 Provider ID: 2180779 Gender: Male Gender: Female Smith III, Charlie MD Mcleod Cardiothoracic Surgical Mcleod Urology Associates Provider ID: 2354543 Asso 800 E Cheves St, Ste 350 Gender: Male 101 S Ravenel St, Ste 270 Florence, SC 29506-2649 Musc Physicians Cardiovascular Florence, SC 29506-2624 (843) 777-7555 Surg (843) 777-7020 Fax: (843) 777-7563 805 Pamplico Hwy, Ste B300 Fax: (843) 664-9545 Mon - Fri 8:00 to 5:00 Florence, SC 29505 Mon - Fri 8:30 to 4:30 PCMH: No (843) 676-2760 PCMH: No Fax: (843) 676-2762 Evans, Brian MD Mon - Fri 8:00 to 5:00 Perry, John MD Provider ID: 1182062 PCMH: No Provider ID: 1570780 Gender: Male Gender: Male Advanced Urology Of The Pee Dee Thoracic Surgery Musc Physicians Cardiovascular LLC Surg 309 W Pine St Carmichael, Michael MD 805 Pamplico Hwy, Ste B300 Florence, SC 29501 Provider ID: 2179723 Florence, SC 29505-6047 (843) 472-5255 Gender: Male (843) 676-2760 Fax: (843) 472-5179 Mcleod Cardiothoracic Surgical Musc Health Florence Medical Mon - Thu 8:30 to 5:00 Asso Center Fri 8:30 to 2:00 101 S Ravenel St, Ste 270 Mon - Fri 8:00 to 5:00 PCMH: No Florence, SC 29506-2624 PCMH: No (843) 777-7020 Fax: (843) 664-9545 Fukuda, Christopher MD Mon - Fri 8:00 to 5:00 Urology Provider ID: 1190179 PCMH: No Gender: Male Bossinger, Steven MD Mcleod Urology Associates Provider ID: 1714313 800 E Cheves St, Ste 350 Holley Jr, Charles MD Gender: Male Florence, SC 29506 Provider ID: 1525834 Mcleod Urology Associates (843) 777-7555 Gender: Male 800 E Cheves St, Ste 350 Fax: (843) 777-7563 Mcleod Cardiothoracic Surgical Florence, SC 29506-2769 Mon - Fri 8:00 to 5:00 Asso (843) 777-7555 PCMH: No 101 S Ravenel St, Ste 270 Fax: (843) 777-7563 Florence, SC 29506-2624 Mon - Fri 8:00 to 5:00 (843) 777-7020 PCMH: No Glinski, Ronald MD Fax: (843) 664-9545 Provider ID: 1812767 Mon - Thu 8:00 to 5:00 Gender: Male Chadbourne, David MD Mcleod Urology Associates Fri 8:00 to 2:00 Provider ID: 2094789 PCMH: No 800 E Cheves St, Ste 350 Gender: Male Florence, SC 29506-2649 Mcleod Urology Associates (843) 777-7555 Huber, Stephen MD 800 E Cheves St, Ste 350 Fax: (843) 777-7563 Provider ID: 957937 Florence, SC 29506-2649 Mon - Fri 8:00 to 5:00 Gender: Male (843) 777-7555 PCMH: No Mcloed Cardiothoracic Surgical Fax: (843) 777-7563 Asso Mon - Thu 8:00 to 5:00 101 S Ravenel St, Ste 270 PCMH: No Florence, SC 29506-2624 (843) 777-7020 Fax: (843) 664-9545 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 78 38642781

Specialty Physicians Florence Urology - cont. O'kelly, James MD Rogus, Bernard MD Provider ID: 495328 Provider ID: 1598350 Horchak, Alex MD Gender: Male Gender: Male Provider ID: 1558423 Mcleod Urology Associates Mcleod Urology Associates Gender: Male 800 E Cheves St, Ste 350 800 E Cheves St, Ste 350 Mcleod Urology Assoc Florence, SC 29506-2649 Florence, SC 29506-2649 800 E Cheves St, Ste 350 (843) 777-7555 (843) 777-7555 Florence, SC 29506-2649 Fax: (843) 777-7563 Fax: (843) 777-7563 (843) 777-7555 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 777-7563 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Okelly, Peter MD Salama, George MD Provider ID: 1563965 Provider ID: 2318454 Hsia, Michael MD Gender: Male Gender: Male Provider ID: 896373 Genesis Health Care Inc. Florence Mcleod Urology Associates Gender: Male 1523 Heritage Ln 800 E Cheves St, Ste 350 Musc Physicians Urology Florence Florence, SC 29505-3197 Florence, SC 29506-2649 Me (843) 673-9992 (843) 777-7555 805 Pamplico Hwy, Ste B-310 Mon - Fri 8:00 to 5:00 Fax: (843) 777-7563 Florence, SC 29505-6068 PCMH: No Mon - Fri 8:00 to 5:00 (843) 673-7525 PCMH: No Fax: (843) 673-7528 Musc Health Florence Medical Rabon, Larry MD Center Provider ID: 769866 Vascular Surgery Gender: Male Mon - Fri 8:00 to 5:00 Piccolo, Carmen DO PCMH: No Larry D Rabon Md 306 S Mcqueen St Provider ID: 1148987 Florence, SC 29501 Gender: Male Maloney, Kelly MD (843) 665-2200 Mcleod Vascular Associates Provider ID: 2027873 Mon - Tue 7:30 to 5:00 101 S Ravenel St, Ste 230 Gender: Female Wed - Fri 8:30 to 5:00 Florence, SC 29506-2624 Mcleod Urology Associates PCMH: No (803) 777-7043 Florence Fax: (803) 777-7041 800 E Cheves St, Ste 350 Mon - Fri 8:00 to 5:00 Florence, SC 29506-2649 Rabon, Larry MD PCMH: No (843) 777-7555 Provider ID: 959019 Fax: (843) 777-7563 Gender: Male Musc Physicians Urology Associates Rzucidlo, Eva MD Mon - Fri 8:00 to 5:00 Provider ID: 1164665 PCMH: No 1594 Freedom Blvd, Ste C203 Florence, SC 29505 Gender: Female (843) 674-1670 Mcleod Vascular Associates Moses, Timothy MD Fax: (843) 674-4707 101 S Ravenel St, Ste 230 Provider ID: 1177408 Musc Health Florence Medical Florence, SC 29506-2624 Gender: Male Center (803) 777-7043 Musc Physicians Urology Florence Mon - Fri 8:00 to 5:00 Fax: (803) 777-7041 Me PCMH: No Mon - Fri 8:00 to 5:00 805 Pamplico Hwy, Ste B-310 PCMH: No Florence, SC 29505 (843) 673-7525 Musc Health Florence Medical Center Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 79 38642781

Specialty Physicians Florence Vascular Surgery - cont. Stonerock, Charles MD Provider ID: 815477 Gender: Male Musc Physicians Cardiovascular Surg 805 Pamplico Hwy, Ste B300 Florence, SC 29505-6019 (843) 676-2760 Fax: (843) 676-2762 Musc Health Florence Medical Center Mon - Fri 8:00 to 5:00 PCMH: No

Winkler, Gabor MD Provider ID: 945371 Gender: Male Mcleod Vascular Associates 101 S Ravenel St, Ste 230 Florence, SC 29506-2624 (843) 777-7043 Fax: (843) 777-7041 Languages: German, Hungarian, Russian Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 80 38642781

Specialty Physicians Horry Addiction Psychiatry Moyer, Joseph MD Goebel, Jason MD Provider ID: 770623 Provider ID: 1040969 Czepowicz, Violetta MD Gender: Male Gender: Male Provider ID: 2022803 Allergy Asthma And Sinus Center Grand Strand Surgical Specialists Gender: Female PC 933 Medical Cir Coastal Carolina Primary Care LLC 5046 Highway 17 Byp S, Ste 105 Myrtle Beach, SC 29572-4116 809 82nd Parkway Myrtle Beach, SC 29588-2606 (843) 497-7772 Myrtle Beach, SC 29572 (843) 293-5000 Fax: (843) 497-7627 (843) 291-7182 Fax: (843) 293-4748 Grand Strand Regional Medical Fax: (843) 291-7182 Mon - Fri 9:00 to 5:00 Center Mon - Fri 8:00 to 5:00 PCMH: No Mon - Thu 9:00 to 5:00 PCMH: No Fri 9:00 to 4:00 Murphy, Thomas MD PCMH: No Allergy & Immunology Provider ID: 1344683 Bennett, Gregory DO Gender: Male Cardiology Charleston ENT Associates - M Provider ID: 1459698 Appleby, Douglas MD Gender: Male 4835 Highway 17, Ste B Murrells Inlet, SC 29576 Provider ID: 2022620 Charleston ENT Associates Gender: Male 4835 Hwy 17 N, Ste B (843) 766-7103 Roper Hospital Grand Strand Surgical Specialists Murrells Inlet, SC 29576 933 Medical Circle (843) 766-7103 Mon - Fri 8:00 to 5:00 PCMH: No Myrtle Beach, SC 29572-4116 Mon - Fri 8:00 to 5:00 (843) 497-7772 PCMH: No Fax: (843) 497-7627 Cardiac Electrophysiology Mon - Fri 9:00 to 5:00 Douglas, Danny MD Goebel, Jason MD PCMH: No Provider ID: 770019 Provider ID: 1040969 Gender: Male Gender: Male Everman, Anne MD 3980 Highway 9 E, Ste 260 809 82nd Pkwy Provider ID: 771204 Little River, SC 29566-8167 Myrtle Beach, SC 29572-4607 Gender: Female (843) 399-9033 (843) 692-1000 Mcleod Cardiology Associates Fax: (843) 399-9051 Grand Strand Regional Medical Myrtle PCMH: No Center 107 Mcleod Health Blvd, Ste 202 PCMH: No Myrtle Beach, SC 29579-4477 Douglas, Danny MD (843) 839-1201 Provider ID: 770019 Goebel, Jason MD Fax: (843) 839-1202 Gender: Male Provider ID: 1040969 Grand Strand Regional Medical 5046 Highway 17 Byp S, Ste 105 Gender: Male Center Myrtle Beach, SC 29588-4503 920 Doug White Dr, Ste 510 Mcleod Loris Seacoast Ho (843) 293-5000 Myrtle Beach, SC 29572 Mon - Thu 8:00 to 5:00 Fax: (843) 293-4748 (843) 497-7772 Fri 8:00 to 1:00 PCMH: No Grand Strand Regional Medical PCMH: No Center Moyer, Joseph MD PCMH: No Provider ID: 770623 Gender: Male Allergy Asthma And Sinus Center PC 3980 Highway 9 E, Ste 260 Little River, SC 29566-2606 (843) 399-9033 Fax: (843) 399-9051 Mon - Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 81 38642781

Specialty Physicians Horry Cardiology - cont. Jackson, William MD Karavan, Mark MD Provider ID: 775644 Provider ID: 204384 Goodroe, Randall MD Gender: Male Gender: Male Provider ID: 874319 Mcleod Cardiology Associates 920 Doug White Dr Gender: Male Myrtle Myrtle Beach, SC 29572 Grand Strand Surgical Specialists 107 Mcleod Health Blvd, Ste 202 (843) 497-7772 199 Vlg Ctr Blvd, Ste 100 Myrtle Beach, SC 29579-4477 Grand Strand Regional Medical Myrtle Beach, SC 29579-3589 (843) 839-1201 Center (843) 497-7772 Fax: (843) 839-1202 PCMH: No Fax: (843) 236-1500 Grand Strand Regional Medical Grand Strand Regional Medical Center Center Kontos, Jimmy MD Mon - Thu 8:00 to 5:00 Provider ID: 875715 Mon - Fri 8:00 to 5:00 Fri 8:00 to 1:00 PCMH: No Gender: Male PCMH: No 920 Doug White Dr, Ste 510 Myrtle Beach, SC 29572 Goodroe, Randall MD Jebaily, Nicholas MD (843) 497-7772 Provider ID: 874319 Provider ID: 2181703 Grand Strand Regional Medical Gender: Male Gender: Male Center Grand Strand Surgical Specialists Mcleod Cardiology Assoc Seacoast PCMH: No 8210 Devon Ct 3980 Highway 9 E, Ste 220 Myrtle Beach, SC 29572-4178 Little River, SC 29566-8164 (843) 497-7772 Kontos, Jimmy MD (843) 390-0877 Provider ID: 875715 Fax: (843) 848-7530 Fax: (843) 390-0881 Grand Strand Regional Medical Gender: Male Mon - Fri 8:00 to 5:00 Grand Strand Gme- Cardiology Center PCMH: No Mon - Thu 9:00 to 5:00 199 Vlg Ctr Blvd, Ste 100 Fri 9:00 to 4:00 Myrtle Beach, SC 29579-3589 PCMH: No Jebaily, Nicholas MD (843) 497-6348 Provider ID: 2181703 Fax: (843) 236-1500 Gender: Male Grand Strand Regional Medical Hicks, John MD Mcleod Cardiology Associates Loris Center Provider ID: 1044597 107 Mcleod Health Blvd, Ste 202 Mon - Fri 8:00 to 5:00 Gender: Male Myrtle Beach, SC 29579-4477 PCMH: No Veritas Cardiovascular And Internal (843) 839-1201 5046 Highway 17 Byp S, Ste 100 Fax: (843) 839-1202 Myrtle Beach, SC 29588-4503 Leask, Gavin MD Mon - Fri 8:00 to 5:00 Provider ID: 773867 (843) 293-5100 PCMH: No Fax: (843) 293-5101 Gender: Male Mon - Thu 9:00 to 5:00 3655 Mitchell St Fri 9:00 to 2:00 Jebaily, Nicholas MD Loris, SC 29569-2827 PCMH: No Provider ID: 2181703 (843) 716-7000 Gender: Male PCMH: No Mcleod Cardiology Assoc Seacoast 3485 Mitchell St, Ste 220 Leask, Gavin MD Loris, SC 29569-2823 Provider ID: 773867 (843) 756-7029 Gender: Male Fax: (843) 756-7033 Pee Dee Cardiology Associates Mon - Fri 8:00 to 5:00 3485 Mitchell St PCMH: No Loris, SC 29569 (843) 756-7029 Fax: (843) 756-7033 Mon - Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 82 38642781

Specialty Physicians Horry Cardiology - cont. Sood, Aditya MD Watson, Jerry MD Provider ID: 2322773 Provider ID: 1016722 Leask, Gavin MD Gender: Male Gender: Male Provider ID: 773867 Cmc Cardiac Care Grand Strand Gme Cardiology Gender: Male 2376 Cypress Cir, Ste 102 809 82nd Pkwy Pee Dee Cardiology Associates Conway, SC 29526 Myrtle Beach, SC 29572-4607 3980 Highway 9 E, Ste 220 (843) 347-8953 (843) 692-1000 Little River, SC 29566 Fax: (843) 347-0226 Grand Strand Regional Medical (843) 390-0877 Mon - Thu 8:00 to 5:00 Center Fax: (843) 390-0881 Fri 8:00 to 12:00 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Cardiovascular Surgery Truluck, David MD Pande, Amit MD Provider ID: 877109 Toole, John MD Provider ID: 773707 Gender: Male Provider ID: 1191104 Gender: Male 920 Doug White Dr Gender: Male Pee Dee Cardiology Associates Myrtle Beach, SC 29572 Roper St. Francis Physician Partner 3485 Mitchell St (843) 977-7772 4630 Hwy 17 N Loris, SC 29569 Grand Strand Regional Medical Murrells Inlet, SC 29576-5016 (843) 756-7029 Center (843) 720-8490 Fax: (843) 756-7033 PCMH: No Fax: (843) 606-8063 Languages: Hindi, Marathi Mon - Fri 9:00 to 5:00 Mon - Fri 9:00 to 5:00 PCMH: No PCMH: No Watson, Jerry MD Provider ID: 1016722 Gender: Male Chiropractic Pande, Amit MD 920 Doug White Dr, Ste 510 Provider ID: 773707 Myrtle Beach, SC 29572 Cline, Matthew DC Gender: Male (843) 497-7772 Provider ID: 775347 Pee Dee Cardiology Associates Grand Strand Regional Medical Gender: Male 3980 Highway 9 E, Ste 220 Center Advantage Health Center Little River, SC 29566 PCMH: No 816 N Main St (843) 390-0877 Aynor, SC 29511 Fax: (843) 390-0881 (843) 358-8003 Languages: Hindi, Marathi Watson, Jerry MD Fax: (843) 358-8004 Mon - Fri 8:00 to 5:00 Provider ID: 1016722 Tue 1:00 to 7:00 PCMH: No Gender: Male Thu 7:00 to 9:00 Grand Strand Gme Cardiology PCMH: No 199 Village Center Blvd, Ste 100 Penmetsa, Ram MD Myrtle Beach, SC 29579-3589 Provider ID: 2391810 (843) 497-6348 Edwards II, Ira DC Gender: Male Fax: (844) 861-1503 Provider ID: 1604440 Cmc Cardiac Care Socastee Grand Strand Regional Medical Gender: Male 6010 Highway 707, Ste 200 Center Palmetto Wellness And Injury Myrtle Beach, SC 29588 Mon - Fri 8:00 to 5:00 Center (843) 347-8953 PCMH: No 1601 N Oak St, Ste 403 Fax: (843) 347-0226 Myrtle Beach, SC 29577-3579 Mon - Thu 8:00 to 5:00 (843) 232-7080 Fri 8:00 to 12:00 Fax: (843) 232-7083 PCMH: No Mon - Thu 8:30 to 5:30 Fri 8:30 to 1:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 83 38642781

Specialty Physicians Horry Chiropractic - cont. Martin, Patrick DC Lagares-Garcia, Jorge MD Provider ID: 773682 Provider ID: 1190920 Edwards II, Ira DC Gender: Male Gender: Male Provider ID: 1604440 PC Martin Chiropractic Inc Roper St Francis Physician Partner Gender: Male 400 Highway 17 N 4630 Highway 17 Palmetto Wellness And Injury Myrtle Beach, SC 29575 Murrells Inlet, SC 29576-5016 Center (843) 238-5900 (843) 958-1281 9250 Highway 17 Byp, Ste B1 Fax: (843) 238-5910 Fax: (843) 958-1278 Murrells Inlt, SC 29576-6619 Mon - Fri 9:00 to 5:00 Mon - Fri 9:00 to 5:00 (843) 668-2999 PCMH: No PCMH: No Mon - Thu 8:30 to 5:30 Fri 8:30 to 1:00 PCMH: No Pellicani, Ronald DC Dermatology Provider ID: 773980 Gender: Male Glover, Mary MD Evans, Jeffrey DC Carolina Forest Chiropractic Provider ID: 1056575 Provider ID: 770879 568 George Bishop Pkwy Gender: Female Gender: Male Myrtle Beach, SC 29579 Grand Strand Dermatology Waccamaw Chiro And Wellness (843) 236-2200 3001 Newcastle Loop 658 Wachesaw Rd Mon - Fri 9:00 to 5:00 Myrtle Beach, SC 29588-4502 Murrells Inlet, SC 29576 PCMH: No (843) 215-1100 (843) 357-9617 Fax: (843) 215-1211 Fax: (843) 357-9639 Mon - Thu 8:00 to 4:00 Mon - Fri 9:00 to 5:00 Walter, Kevin DC Fri 8:00 to 12:00 PCMH: No Provider ID: 776563 PCMH: No Gender: Male Walter Kevin M Evans, John DC 513 Highway 17 N Glover, Mary MD Provider ID: 771908 North Myrtle Beach, SC Provider ID: 1056575 Gender: Male 29582-2903 Gender: Female Waccamaw Chiropractic Wellness (843) 280-7000 Grand Strand Dermatology Cen Fax: (843) 280-7001 933 Medical Cir 658 Wachesaw Rd Mon - Fri 9:00 to 5:00 Myrtle Beach, SC 29572-4116 Murrells Inlet, SC 29576 PCMH: No (843) 215-1100 (843) 357-9617 Fax: (843) 215-1211 Fax: (843) 357-9639 Mon - Fri 9:00 to 5:00 Mon - Fri 9:00 to 5:00 Colon & Rectal Surgery PCMH: No PCMH: No Firilas, Anthony MD Provider ID: 1190761 Jones, Nathan MD Hemingway, Jenica DC Gender: Male Provider ID: 773747 Provider ID: 1720914 Roper St Francis Physician Partners Gender: Male Gender: Female 4630 Highway 17 Grand Strand Dermatology Hemingway Family Chiropractic Murrells Inlet, SC 29576-5016 933 Medical Cir LLC (843) 958-1281 Myrtle Beach, SC 29572-4116 1293 Professional Dr, Ste 102a Fax: (843) 958-1278 (843) 215-1100 Myrtle Beach, SC 29577 Mon - Fri 9:00 to 5:00 Fax: (843) 215-1211 (849) 250-3876 PCMH: No Mon - Fri 9:00 to 5:00 Fax: (843) 839-9831 PCMH: No Mon - Thu, Sat 7:30 to 5:00 Fri 7:30 to 2:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 84 38642781

Specialty Physicians Horry Dermatology - cont. Skvarka, Christopher MD Coastal Carolina Otolaryngology Provider ID: 771968 Jones, Nathan MD Gender: Male Provider ID: 773485 Provider ID: 773747 Grand Strand Dermatology 1120 Glenns Bay Rd Gender: Male 933 Medical Cir Myrtle Beach, SC 29575 Grand Strand Dermotology LLC Myrtle Beach, SC 29572-4116 (843) 215-1068 3001 Newcastle Loop (843) 215-1100 Fax: (843) 215-1074 Myrtle Beach, SC 29588 Fax: (843) 215-1211 Mon - Thu 8:00 to 5:00 (843) 215-1100 Mon - Fri 9:00 to 5:00 Fri 9:00 to 5:00 Fax: (843) 215-1211 PCMH: No PCMH: No Mon - Thu 8:00 to 4:00 Fri 8:00 to 12:00 PCMH: No Skvarka, Christopher MD Jordan, Robert MD Provider ID: 771968 Provider ID: 773964 Gender: Male Gender: Male Nambudiri, Vinod MD Grand Strand Dermatology LLC Charleston ENT Associates Provider ID: 1431349 3001 Newcastle Loop 4835 Highway 17, Ste B Gender: Male Myrtle Beach, SC 29588 Murrells Inlet, SC 29576 Coastal Carolina Primary Care LLC (843) 215-1100 (843) 766-7103 8170 Rourk St, Ste 100 Fax: (843) 215-1211 Mon - Fri 8:00 to 5:00 Myrtle Beach, SC 29572 Mon - Fri 8:00 to 3:30 PCMH: No (843) 497-7772 PCMH: No Fax: (843) 236-7952 Mon - Thu 8:30 to 4:30 Lee, Jessica MD Fri 8:30 to 4:00 Ear Nose & Throat Provider ID: 1293882 PCMH: No Gender: Female Bondy, Peter MD Charleston ENT Associates Provider ID: 973022 4835 Highway 17, Ste B Purvis, Robert MD Gender: Male Murrells Inlet, SC 29576 Provider ID: 770929 Cmc ENT (843) 766-7103 Gender: Male 808 Farrar Dr Mon - Fri 8:00 to 5:00 Grand Strand Dermatology Conway, SC 29526-8747 PCMH: No 3001 Newcastle Loop (843) 347-7300 Myrtle Beach, SC 29588 Fax: (843) 347-8459 (843) 215-1100 Languages: Spanish Norton, Julien MD Fax: (843) 215-1211 Mon - Fri 8:00 to 5:00 Provider ID: 1467826 Mon - Thu 8:00 to 5:00 PCMH: No Gender: Male Fri 8:00 to 12:00 Charleston ENT Associates PCMH: No 4835 Highway 17 North, Ste B Coastal Carolina Otolaryngology Murrells Inlet, SC 29576 (843) 766-7103 Purvis, Robert MD Provider ID: 773485 Mon - Fri 8:00 to 5:00 Provider ID: 770929 1021 Cipriana Dr, Ste 220 PCMH: No Gender: Male Myrtle Beach, SC 29572-4116 Grand Strand Dermatology (843) 449-6449 933 Medical Cir Fax: (843) 449-1069 Novis, Sarah MD Myrtle Beach, SC 29572-4116 Mon - Fri 8:00 to 5:00 Provider ID: 1464858 (843) 215-1100 PCMH: No Gender: Female Fax: (843) 215-1211 Mcleod ENT Seacoast Mon - Fri 9:00 to 5:00 3980 Hwy 9 E, Ste 340 PCMH: No Little River, SC 29566-8165 (843) 366-3040 Fax: (843) 366-3041 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 85 38642781

Specialty Physicians Horry Ear Nose & Throat - cont. Rosner, Daniel MD Nicol, Philip MD Provider ID: 770733 Provider ID: 772896 Osman, Richard MD Gender: Male Gender: Male Provider ID: 772242 Coastal Carolina Otolaryngology Georgetown Physician Associates Gender: Male Ass LLC 1120 Glenns Bay Rd, Ste 117 1021 Cipriana Dr, Ste 220 11891 Plaza Dr Surfside Beach, SC 29575-4757 Myrtle Beach, SC 29572-4116 Murrells Inlet, SC 29576 (843) 650-1003 (843) 449-6449 (843) 353-0288 Fax: (843) 215-1074 Fax: (843) 449-1069 Fax: (843) 357-9770 Grande Dunes Surgery Center Grande Dunes Surgery Center Mon - Fri 8:00 to 4:30 PCMH: No Mon - Thu 8:00 to 5:00 PCMH: No Fri 9:00 to 5:00 Osman, Richard MD PCMH: No Family Practice Provider ID: 772242 Gender: Male Sutton, Darin MD Bleyer, Peter MD Coastal Carolina Otolaryngology Provider ID: 916823 Provider ID: 1313831 Ass Gender: Male Gender: Male 1021 Cipriana Dr, Ste 220 Cmc ENT Healogics Specialty Physicians Of S Myrtle Beach, SC 29572-4116 808 Farrar Dr 300 Singleton Ridge Rd (843) 449-6449 Conway, SC 29526-8747 Conway, SC 29526-9142 Fax: (843) 449-1069 (843) 347-7300 (843) 347-8347 Grande Dunes Surgery Center Fax: (843) 347-8459 Mon - Fri 8:00 to 5:00 Mon - Thu 8:00 to 5:00 Languages: Spanish PCMH: No Fri 9:00 to 5:00 Mon - Fri 8:30 to 5:30 PCMH: No PCMH: No Howard, Thomas MD Provider ID: 774387 Reid, Carol MD Endocrinology Diabetes Metabolism Gender: Male Provider ID: 2378021 South Strand Internists And Urgent Gender: Female Haenel, Louis DO 1945 Glenns Bay Rd Tidelands Health ENT Associates Provider ID: 1190815 Myrtle Beach, SC 29575-4833 2200 Crow Ln, Ste 301 Roper St Francis Physician Partners (843) 650-4006 Myrtle Beach, SC 29577-1663 4630 Highway 17 Fax: (843) 650-4019 (843) 652-8390 Murrells Inlet, SC 29576-5016 Mon - Fri 8:00 to 5:00 Fax: (843) 652-8399 (843) 724-2011 PCMH: No Mon - Fri 8:30 to 5:00 Fax: (840) 606-7991 PCMH: No Mon - Fri 9:00 to 5:00 Solheim, Vesna MD PCMH: No Provider ID: 1173942 Rosner, Daniel MD Gender: Female Provider ID: 770733 Kleess, Lauren MD Solheim Family Practice Gender: Male Provider ID: 2206753 12082 Highway 17 Byp, Unit B 1120 Glenns Bay Rd, Ste 117 Gender: Female Murrells Inlet, SC 29576-9350 Surfside Beach, SC 29575-4757 Cmc Endocrinology (843) 900-0777 (843) 215-1068 2376 Cypress Cir, Ste 202 Fax: (843) 900-0780 Fax: (843) 215-1074 Conway, SC 29526-8994 Mon - Fri 9:00 to 5:00 Grande Dunes Surgery Center (843) 234-9700 PCMH: No PCMH: No Fax: (843) 234-6896 Mon - Thu 8:30 to 5:00 Fri 8:30 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 86 38642781

Specialty Physicians Horry Family Practice - cont. Bach, Christopher MD Cornnell, Timothy MD Provider ID: 1408332 Provider ID: 770657 Stranckmeyer, Shawn MD Gender: Male Gender: Male Provider ID: 1547459 Georgetown Physician Associates Ll Cardiology Gastroenterology Gender: Male 4040 Highway 17, Ste 302 Associa Elite Pain Management Murrells Inlet, SC 29576-5098 945 82nd Pkwy, Ste 3 4237 River Hills Dr, Ste 170 (843) 652-8290 Myrtle Beach, SC 29572 Little River, SC 29566-6446 Fax: (843) 652-8299 (843) 449-3381 (843) 273-0376 Mon - Fri 8:30 to 5:00 Fax: (843) 839-0275 Fax: (843) 273-4516 PCMH: No Mon - Fri 9:00 to 5:00 Mon - Fri 9:00 to 5:30 PCMH: No PCMH: No Bach, Christopher MD Provider ID: 1408332 Edmison, John MD Stranckmeyer, Shawn MD Gender: Male Provider ID: 1539793 Provider ID: 1547459 Georgetown Physician Associates Ll Gender: Male Gender: Male 4301 Dick Pond Rd Strand Gi Associates Pa Elite Pain Management LLC Myrtle Beach, SC 29588-6807 945 82nd Pkwy, Ste 3a 8212 Devon Ct (843) 652-8290 Myrtle Beach, SC 29572-4612 Myrtle Beach, SC 29572-4178 Fax: (843) 652-8299 (843) 449-3381 (843) 273-0376 Mon - Fri 9:00 to 5:00 Fax: (843) 839-0275 Fax: (843) 273-4516 PCMH: No Mon - Fri 7:00 to 5:00 Mon - Fri 8:30 to 5:00 PCMH: No PCMH: No Benson, Paul MD Provider ID: 1555607 Eisenman, Richard MD Gastroenterology Gender: Male Provider ID: 900798 Abadie, Sebastian MD Georgetown Physician Associates Ll Gender: Male Provider ID: 1260987 4040 Hwy 17 Bypass, Ste 302 300 Singleton Ridge Rd Gender: Male Murrells Inlet, SC 29576 Conway, SC 29526-9142 Georgetown Physician Associates (843) 652-8290 (843) 347-7111 LLC Fax: (843) 652-8299 PCMH: No 4040 Highway 17, Ste 302 Mon - Fri 8:30 to 5:00 Murrells Inlet, SC 29576-5098 PCMH: No Eisenman, Richard MD (843) 652-8290 Provider ID: 900798 Fax: (843) 652-8299 Charbel, Samer MD Gender: Male Mon - Fri 8:30 to 5:00 Provider ID: 1035598 Cmc Digestive Health PCMH: No Gender: Male 2376 Cypress Cir, Ste 203 Cmc Digestive Health Conway, SC 29526-8994 Abadie, Sebastian MD 2376 Cypress Cir, Ste 203 (843) 347-6038 Provider ID: 1260987 Conway, SC 29526-8994 Fax: (843) 347-9808 Gender: Male (843) 347-6038 Mon - Thu 9:00 to 5:00 Georgetown Physician Associates Fax: (843) 347-9808 Fri 9:00 to 1:00 LLC Languages: Arabic, French PCMH: No 4301 Dick Pond Rd Mon - Thu 8:00 to 5:00 Myrtle Beach, SC 29588-6807 Fri 8:00 to 1:00 Elraie, Khaled MD (843) 652-8290 PCMH: No Provider ID: 1168102 Fax: (843) 652-8299 Gender: Male Mon - Fri 8:30 to 5:00 Mcleod Digestive Health Center PCMH: No Seac 107 Mcleod Health Blvd, Ste 207 Myrtle Beach, SC 29579-4477 (843) 366-3715 Fax: (843) 366-3716 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 87 38642781

Specialty Physicians Horry Gastroenterology - cont. Pearson, Andrew MD Vukov, Gary MD Provider ID: 772054 Provider ID: 769937 Elraie, Khaled MD Gender: Male Gender: Male Provider ID: 1168102 809 82nd Pkwy Cardiology Gastroenterology Gender: Male Myrtle Beach, SC 29572-4607 Associa Mcleod Digestive Health Center (843) 692-1000 945 82nd Pkwy, Ste 3 Seac PCMH: No Myrtle Beach, SC 29572 3980 Highway 9 E, Ste 320 (843) 449-3381 Little River, SC 29566-8165 Fax: (843) 449-9721 (843) 366-3715 Poland, Emily DO Provider ID: 1214845 Mon - Fri 9:00 to 5:00 Fax: (843) 366-3716 PCMH: No Mon - Fri 8:00 to 5:00 Gender: Female PCMH: No Georgetown Physician Associates LLC General Practice 4040 Highway 17, Ste 3602 Hernandez, Jose MD Murrells Inlet, SC 29576 Scott, Brian MD Provider ID: 1856995 (843) 235-3131 Provider ID: 1778673 Gender: Male Fax: (843) 237-9797 Gender: Male Strand Gi Associates Mon - Fri 8:30 to 5:00 Forest Family Care 945 82nd Pkwy, Ste 3a PCMH: No 3874 Renee Dr, Unit B Myrtle Beach, SC 29572-4612 Myrtle Beach, SC 29579-4358 (843) 449-3381 (843) 903-4500 Fax: (843) 449-9721 Poland, Emily DO Fax: (843) 903-4505 Mon - Thu 8:00 to 5:00 Provider ID: 1214845 Mon - Fri 8:00 to 5:00 Fri 8:00 to 1:00 Gender: Female PCMH: No PCMH: No Georgetown Physician Associates LLC 4301 Dick Pond Rd General Surgery Malone, Meghan MD Myrtle Beach, SC 29588-6807 Provider ID: 813316 Bednarski, Hania DO (843) 235-3131 Provider ID: 2222418 Gender: Female Fax: (843) 237-9797 Cmc Digestive Health Gender: Female Mon - Fri 9:00 to 5:00 Grand Strand Surgical Specialists 2376 Cypress Cir, Ste 203 PCMH: No Conway, SC 29526-8994 920 Doug White Dr, Ste 430 (843) 347-6038 Myrtle Beach, SC 29572-4182 Fax: (843) 347-9808 Raynor, Kathleen MD (843) 497-6348 Mon - Thu 9:00 to 5:00 Provider ID: 1323565 Fax: (843) 497-6351 Fri 9:00 to 12:00 Gender: Female Mon - Fri 8:00 to 5:00 PCMH: No Cardiology Gastroenterology PCMH: No Associa 945 82nd Pkwy, Ste 3 Pearson, Andrew MD Bjerken, David MD Myrtle Beach, SC 29572 Provider ID: 1143766 Provider ID: 772054 (843) 449-3381 Gender: Male Gender: Male Fax: (843) 839-0275 Mcleod Vascular Associates Cardiology Gastroenterology Mon - Thu 8:00 to 5:00 Associa Seacoast Fri 8:00 to 1:00 3617 Casey St, Ste C 945 82nd Pkwy, Ste 3 PCMH: No Myrtle Beach, SC 29572 Loris, SC 29569-2981 (843) 449-3381 (843) 716-8940 Fax: (843) 839-0275 Fax: (843) 716-9760 Mon - Fri 9:00 to 5:00 Mcleod Regional Medical Center PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 88 38642781

Specialty Physicians Horry General Surgery - cont. Cobos, Rachel MD Farrah, Jason MD Provider ID: 1821668 Provider ID: 1802649 Bjerken, David MD Gender: Female Gender: Male Provider ID: 1143766 Grand Strand Surgical Specialists Grand Strand Surgical Specialists Gender: Male 849 82nd Pkwy 849 82nd Pkwy Mcleod Vascular Associates Myrtle Beach, SC 29572-4614 Myrtle Beach, SC 29572-4614 Seacoast (843) 497-6348 (843) 497-6348 3980 Highway 9 E, Ste 240 Fax: (843) 497-6351 Fax: (843) 497-6351 Little River, SC 29566-8164 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 (843) 366-3755 PCMH: No PCMH: No Fax: (843) 366-3750 Mcleod Regional Medical Center Mon - Fri 8:00 to 5:00 Epstein, Aaron MD Foreman, Thomas MD PCMH: No Provider ID: 1789395 Provider ID: 1471297 Gender: Male Gender: Male Cmc Surgical Associates Healogics Specialty Physicians Of S Brackett, Newton MD 2361 Cypress Cir 5050 Hwy 17 Bypass S Provider ID: 1336916 Conway, SC 29526-8921 Myrtle Beach, SC 29588 Gender: Male (843) 347-7291 (843) 692-4540 Georgetown Physician Associates Ll Fax: (843) 347-9309 Fax: (843) 839-6006 8203 Nigels Dr Mon - Thu 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Myrtle Beach, SC 29572-4177 Fri 8:00 to 12:00 PCMH: No (843) 651-3308 PCMH: No Fax: (843) 651-4629 Thu 8:00 to 12:00 Glaser, Jacob MD PCMH: No Epstein, Aaron MD Provider ID: 1727168 Provider ID: 776823 Gender: Male Gender: Male Grand Strand Surgical Specialists Brackett, Newton MD 300 Singleton Ridge Rd 849 82nd Pkwy Provider ID: 1336916 Conway, SC 29526-9142 Myrtle Beach, SC 29572-4614 Gender: Male (843) 347-7111 (843) 497-6348 Georgetown Physicians Associates PCMH: No Fax: (843) 497-6351 Ll Mon - Thu 8:00 to 5:00 4181 Highway 17 Epstein, Aaron MD Fri 8:00 to 4:00 Murrells Inlet, SC 29576-5019 PCMH: No (843) 651-3308 Provider ID: 776823 Fax: (843) 651-4629 Gender: Male Mon, Thu - Fri 12:30 to 5:00 Associates In Surgery Johnson, Alan MD Wed 9:00 to 5:00 2361 Cypress Cir Provider ID: 2023281 PCMH: No Conway, SC 29526 Gender: Male (843) 347-7291 Grand Strand Surgical Specialists Fax: (843) 347-9309 933 Medical Circle Brockman, Robert MD Mon - Thu 8:00 to 5:00 Myrtle Beach, SC 29572-4116 Provider ID: 1218886 Fri 8:00 to 12:00 (843) 497-7772 Gender: Male PCMH: No Fax: (843) 497-7627 Georgetown Physician Associates Mon - Fri 9:00 to 5:00 LLC PCMH: No 4040 Highway 17, Ste 202 Epstein, Aaron MD Murrells Inlet, SC 29576-5098 Provider ID: 776823 (843) 652-8390 Gender: Male Fax: (843) 652-8399 Associates In Surgery Mon - Fri 8:30 to 5:00 4361 Riverwood Dr, Ste 210 PCMH: No Murrells Inlet, SC 29576 (843) 347-7291 Fax: (843) 347-9301 Tue - Wed 8:30 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 89 38642781

Specialty Physicians Horry General Surgery - cont. Mcintyre, Alex MD Mincey, Kenneth MD Provider ID: 1854093 Provider ID: 775799 Lew, Michael MD Gender: Male Gender: Male Provider ID: 2014308 Healogics Specialty Physicians Of S Mcleod Loris Seacoast Surgery Gender: Male 5050 Highway 17 Byp S 3980 Highway 9 E, Ste 310 Cmc Surgical Associates Myrtle Beach, SC 29588-4500 Little River, SC 29566-8165 2361 Cypress Cir (843) 692-4540 (843) 399-9774 Conway, SC 29526-8921 Fax: (843) 839-6006 Fax: (843) 399-8657 (843) 347-7291 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 347-0139 PCMH: No PCMH: No Mon - Thu 8:00 to 5:00 Fri 8:00 to 12:00 PCMH: No Mijalli, Mamdouh MD Mislowsky, Angela MD Provider ID: 771737 Provider ID: 775732 Gender: Male Gender: Female Matzinger, Steven MD Mcleod Loris Seacoast Surgery Coastal Carolina Breast Center Provider ID: 848104 3980 Highway 9 E, Ste 310 4181 Highway 17 Gender: Male Little River, SC 29566-8165 Murrells Inlet, SC 29576 Grand Strand Surgical Specialists (843) 399-9774 (843) 651-3308 199 Village Center Blvd, Ste 100 Fax: (843) 399-8657 Fax: (843) 651-4629 Myrtle Beach, SC 29579-3589 Mon - Fri 8:00 to 5:00 Mon - Thu 9:00 to 5:00 (843) 497-7772 PCMH: No Fri 9:00 to 12:00 Fax: (843) 236-1500 PCMH: No Grand Strand Regional Medical Center Mijalli, Mamdouh MD Mon - Thu 8:30 to 5:00 Provider ID: 771737 Mislowsky, Angela MD Fri 8:30 to 4:00 Gender: Male Provider ID: 951018 PCMH: No Mcleod Loris Seacoast Surgery Gender: Female 107 Mcleod Health Blvd, Ste 201 Georgetown Physician Associates Myrtle Beach, SC 29579-4477 LLC Mccrae, Allison MD (843) 399-9774 4181 Hwy 17 Bypass Provider ID: 1728704 Fax: (843) 399-8657 Murrells Inlet, SC 29576-5019 Gender: Female Mon - Fri 8:00 to 5:00 (843) 651-3308 Grand Strand Surgical Care PCMH: No Fax: (843) 651-4629 849 82nd Pkwy Mon - Tue, Fri 12:30 to 5:00 Myrtle Beach, SC 29572-4614 Mijalli, Mamdouh MD Wed 9:00 to 5:00 (843) 497-6348 PCMH: No Fax: (843) 497-6351 Provider ID: 771737 Mon - Fri 8:00 to 5:00 Gender: Male PCMH: No Mcleod Loris Seacoast Surgery Mislowsky, Angela MD 3617 Casey St, Ste D Provider ID: 951018 Loris, SC 29569-2981 Gender: Female Mcintyre, Alex MD (843) 756-3150 Georgetown Physician Associates Provider ID: 1854093 Fax: (843) 756-4787 LLC Gender: Male Mon - Fri 8:00 to 5:00 8203 Nigels Dr Healogics Specialty Physicians Of S PCMH: No Myrtle Beach, SC 29572-4177 300 Singleton Ridge Rd (843) 651-3308 Conway, SC 29526-9142 Fax: (843) 651-4629 (843) 347-8347 Mincey, Kenneth MD Provider ID: 775799 Tue 8:00 to 12:00 Fax: (904) 446-3032 PCMH: No Mon - Fri 8:00 to 5:00 Gender: Male PCMH: No Mcleod Loris Seacoast Surgery 3617 Casey St, Ste D Loris, SC 29569-2981 (843) 756-3150 Fax: (843) 399-8657 Mon - Fri 8:30 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 90 38642781

Specialty Physicians Horry General Surgery - cont. Pinnola, Aaron DO Poole, Trevor MD Provider ID: 2235425 Provider ID: 1235971 Nuwayhid, Zaher MD Gender: Male Gender: Male Provider ID: 1537503 Grand Strand Surgical Specialists Southern Surgical Associates Gender: Male 199 Vlg Ctr Blvd, Ste 100 3600 Sea Mountain Hwy, Ste A Cpg Bariatric And General Surgery Myrtle Beach, SC 29579-3589 Little River, SC 29566 2376 Cypress Cir, Ste 103 (843) 497-6348 (843) 399-9095 Conway, SC 29526-8964 Fax: (843) 497-6351 Fax: (843) 399-9098 (843) 347-3900 Mon - Fri 8:00 to 5:00 Languages: Spanish Fax: (843) 347-3930 PCMH: No Mon - Thu 9:00 to 5:00 Mon - Thu 8:30 to 5:00 Fri 9:00 to 3:00 Fri 8:30 to 1:00 PCMH: No PCMH: No Poole, Trevor MD Provider ID: 1235971 Gender: Male Rimkus, Gilbertas MD Piacentino, Valentino MD Grand Dunes Surgery Center Provider ID: 1788042 Provider ID: 1728437 1021 Cipriana Dr, Ste 100 Gender: Male Gender: Male Myrtle Beach, SC 29572 Cmc Surgical Associates Grand Strand Surgical Specialists (843) 449-7885 2361 Cypress Cir 199 Village Center Blvd, Ste 100 Fax: (843) 497-5395 Conway, SC 29526 Myrtle Beach, SC 29579-3589 Languages: Spanish (843) 347-7291 (843) 497-6348 Mon - Thu 9:00 to 5:00 Fax: (843) 347-0139 Fax: (844) 861-1500 Fri 9:00 to 3:00 Mon - Thu 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No Fri 8:00 to 12:00 PCMH: No PCMH: No Poole, Trevor MD Piacentino, Valentino MD Provider ID: 1235971 Rimkus, Gilbertas MD Provider ID: 1728437 Gender: Male Provider ID: 772134 Gender: Male Mcleod Loris Gender: Male Grand Strand Surgical Specialists 3655 Mitchell St Associates In Surgery 849 82nd Pkwy Little River, SC 29566 2361 Cypress Cir Myrtle Beach, SC 29572-4614 (843) 716-7000 Conway, SC 29526 (843) 497-6348 Fax: (843) 399-9098 (843) 347-7291 Fax: (843) 497-6351 Languages: Spanish Fax: (843) 347-9309 Mon - Thu 8:00 to 5:00 Mon - Thu 9:00 to 5:00 Mon - Thu 8:00 to 5:00 Fri 8:00 to 4:00 Fri 9:00 to 3:00 Fri 8:00 to 12:00 PCMH: No PCMH: No PCMH: No

Piacentino, Valentino MD Poole, Trevor MD Sasser, Paul MD Provider ID: 1728437 Provider ID: 1235971 Provider ID: 1795584 Gender: Male Gender: Male Gender: Male Waterway Primary Care LLC Mcleod Seacoast Cmc Surgical Associates 4237 River Hills Dr, Ste 150 400 Highway 9 East 2361 Cypress Cir Little River, SC 29566-6446 Little River, SC 29566 Conway, SC 29526-8921 (843) 281-2778 (843) 390-8100 (843) 347-7291 Mon - Fri 8:00 to 5:00 Fax: (843) 399-9098 Fax: (843) 347-9309 PCMH: No Languages: Spanish Mon - Thu 8:00 to 5:00 Mon - Thu 9:00 to 5:00 Fri 8:00 to 12:00 Fri 9:00 to 3:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 91 38642781

Specialty Physicians Horry General Surgery - cont. Sibille, Joshua MD Hand Surgery Provider ID: 1435301 Sasser, Paul MD Gender: Male Duncan V, Scott MD Provider ID: 770841 Mcleod Vascular Associates Provider ID: 1472090 Gender: Male Seacoast Gender: Male Sasser Medical Associates LLC 3980 Highway 9 E, Ste 240 Grand Strand Gme Program - 2361 Cypress Cir Little River, SC 29566-8164 Surgery Conway, SC 29526 (843) 366-3755 8170 Rourk St, Ste 150 (843) 347-7291 Fax: (843) 366-3750 Myrtle Beach, SC 29572-4127 Fax: (843) 347-9309 Mon - Fri 8:00 to 5:00 (843) 848-1440 Mon - Thu 9:00 to 4:00 PCMH: No Fax: (843) 839-1654 Fri 9:00 to 5:00 Mon - Thu 8:00 to 5:00 PCMH: No Fri 8:00 to 4:00 Witkowski, Mark DO PCMH: No Provider ID: 1237882 Sasser, Paul MD Gender: Male Provider ID: 770842 Georgetown Physician Associates Duncan V, Scott MD Gender: Male LLC Provider ID: 1472090 Associates In Surgery 4040 Highway 17, Suite 202 Gender: Male 2361 Cypress Cir Murrells Inlet, SC 29576-5098 Grand Strand Gme Program - Conway, SC 29526 (843) 652-8390 Surgery (843) 347-7291 Fax: (843) 652-8399 849 82nd Pkwy Fax: (843) 347-9309 Mon - Fri 8:30 to 5:00 Myrtle Beach, SC 29572 Mon - Thu 8:00 to 5:00 PCMH: No (843) 497-6348 Fri 8:00 to 12:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Young, Eric MD Provider ID: 771079 Sasser, Paul MD Gender: Male Lukowski, David MD Provider ID: 770842 Mcleod Loris Seacoast Surgery Provider ID: 776517 Gender: Male 3617 Casey St, Ste D Gender: Male 4036 River Oaks Dr, Ste B2 Loris, SC 29569-2981 Mcleod Orthopaedic Associates Myrtle Beach, SC 29579-6695 (843) 756-3150 3980 Highway 9 E, Ste 200 (843) 796-1721 Fax: (843) 399-8657 Little River, SC 29566-8164 Fax: (843) 796-1916 Mon - Fri 8:30 to 5:00 (843) 390-0100 PCMH: No PCMH: No Fax: (843) 390-0038 Mon - Fri 9:00 to 5:00 PCMH: No Sciarretta, Jason MD Young, Eric MD Provider ID: 2025736 Provider ID: 771079 Gender: Male Gender: Male Hematology & Oncology Grand Strand Surgical Specialists Mcleod Loris Seacoast Surgery Adams, Sara MD 849 82nd Pkwy 3980 Highway 9 E, Ste 310 Myrtle Beach, SC 29572-4614 Provider ID: 882899 Little River, SC 29566-8165 Gender: Female (843) 497-6348 (843) 399-9774 Fax: (843) 497-6351 Georgetown Physician Associates Fax: (843) 399-8657 LLC Mon - Fri 8:30 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No 1220 21st Ave N PCMH: No Myrtle Beach, SC 29577-7401 (843) 652-3600 Fax: (843) 652-3602 Mon - Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 92 38642781

Specialty Physicians Horry Hematology & Oncology - cont. Haughton, Michael MD Thumallapally, Nishitha MD Provider ID: 1238810 Adams, Sara MD Gender: Male Provider ID: 2339520 Provider ID: 882899 Georgetown Physician Associates Gender: Female Gender: Female LLC Cmc Cancer Center Georgetown Physician Associates 4181 Highway 17 300 Singleton Ridge Rd LLC Murrells Inlet, SC 29576-5019 Conway, SC 29526-9142 4181 Hwy 17 Bypass (843) 652-3600 (843) 347-8050 Murrells Inlet, SC 29576 Fax: (843) 652-3602 Fax: (843) 347-8049 (843) 652-3600 Mon - Fri 9:00 to 5:00 Languages: Hindi, Telugu Fax: (843) 652-3602 PCMH: No Mon - Fri 8:00 to 5:00 Mon - Fri 8:30 to 5:00 PCMH: No PCMH: No Haughton, Michael MD Provider ID: 1238810 Touloukian, Emily DO Brown, Dejuania DO Gender: Male Provider ID: 1973739 Provider ID: 1974031 Georgetown Physician Associates Gender: Female Gender: Female LLC Associated Medical Specialists Pa Associated Medical Specialists Pa 1220 21st Ave N 3008 Bayboro St 8121 Rourk St Myrtle Beach, SC 29577-7401 Loris, SC 29569-2714 Myrtle Beach, SC 29572-4128 (843) 652-8300 (843) 756-0932 (843) 692-5000 Fax: (843) 652-8301 Fax: (843) 756-0508 Fax: (843) 692-5010 Mon - Fri 9:00 to 5:00 Mon - Thu 8:00 to 4:30 Mon - Thu 7:30 to 5:00 PCMH: No Fri 8:00 to 3:00 Fri 7:30 to 3:00 PCMH: No Sat - Sun 8:00 to 12:00 PCMH: No Henderson, Jordan DO Provider ID: 1977118 Touloukian, Emily DO Gender: Male Provider ID: 1973739 Goldberg, Renwick MD Associated Medical Specialists Pa Gender: Female Provider ID: 1973291 8121 Rourk St Associated Medical Specialists Pa Gender: Male Myrtle Beach, SC 29572-4128 8121 Rourk St Associated Medical Specialists Pa (843) 692-5000 Myrtle Beach, SC 29572-4128 8121 Rourk St Fax: (843) 692-5010 (843) 692-5000 Myrtle Beach, SC 29572-4128 Mon - Thu 7:30 to 5:00 Fax: (843) 692-5010 (843) 695-5000 Fri 7:30 to 3:00 Mon - Fri 7:30 to 5:00 Fax: (843) 429-5010 Sat - Sun 9:00 to 12:00 Sat - Sun 9:00 to 12:00 Mon - Thu 7:30 to 5:00 PCMH: No PCMH: No Fri 7:30 to 3:00 Sat - Sun 9:00 to 12:00 PCMH: No Huynh, Donny MD Infectious Disease Provider ID: 1477274 Gender: Male Ebama, Nyabilondi MD Goldberg, Renwick MD Mcleod Oncology Hematology Provider ID: 773300 Provider ID: 1973291 Seacoas Gender: Female Gender: Male 3980 Highway 9 E, Ste 300 Lowcountry Infectious Diseases Pa Associated Medical Specialists Pa Little River, SC 29566-8165 128 Pro Park Dr, Unit B 817 Farrar Dr (843) 366-3891 Conway, SC 29526 Conway, SC 29526-8747 Fax: (843) 366-3892 (843) 449-1640 (843) 234-1660 Mon - Fri 8:00 to 5:00 Fax: (843) 449-1605 Fax: (843) 234-1661 PCMH: No Mon - Fri 8:00 to 4:30 Mon, Wed - Thu 8:00 to 4:30 PCMH: No Tue 8:00 to 4:00 Fri 8:00 to 3:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 93 38642781

Specialty Physicians Horry Infectious Disease - cont. Shea, Kevin MD Adams, Sara MD Provider ID: 2224257 Provider ID: 882899 Osmanzai, Yama MD Gender: Male Gender: Female Provider ID: 1225633 Coastal Carolina Primary Care LLC Georgetown Physician Associates Gender: Male 920 Doug White Drive, Ste 250 LLC Coastal Carolina Infectious Disease Myrtle Beach, SC 29572-4120 1220 21st Ave N 1039 44th Ave N, Ste 204 (843) 236-1950 Myrtle Beach, SC 29577-7401 Myrtle Beach, SC 29577 Fax: (843) 236-1952 (843) 652-3600 (843) 443-4232 Mon - Fri 8:00 to 5:00 Fax: (843) 652-3602 Fax: (843) 443-4229 PCMH: No Mon - Fri 9:00 to 5:00 Thu 12:00 to 5:00 PCMH: No Fri 8:00 to 4:00 PCMH: No West, Timothy MD Provider ID: 776175 Adams, Sara MD Gender: Male Provider ID: 882899 Osmanzai, Yama MD Lowcountry Infectious Gender: Female Provider ID: 1225633 931 Medical Cir Georgetown Physician Associates Gender: Male Myrtle Beach, SC 29572 LLC 1110 London St, Ste 102 (843) 449-1640 4181 Hwy 17 Bypass Myrtle Beach, SC 29577-5799 Fax: (843) 449-1605 Murrells Inlet, SC 29576 (843) 668-2376 Mon - Fri 9:00 to 5:00 (843) 652-3600 Fax: (843) 748-0613 PCMH: No Fax: (843) 652-3602 PCMH: No Mon - Fri 8:30 to 5:00 Internal Medicine PCMH: No Powers, James MD Provider ID: 1526480 Abadie, Sebastian MD Almeida, Nathan MD Gender: Male Provider ID: 1260987 Provider ID: 774862 Strand Infectious Disease PC Gender: Male Gender: Male 831 82nd Pkwy Georgetown Physician Associates Pee Dee Cardiology Associates Myrtle Beach, SC 29572-4607 LLC 3980 Highway 9 E, Ste 220 (843) 839-0135 4040 Highway 17, Ste 302 Little River, SC 29566-8164 Fax: (843) 449-2333 Murrells Inlet, SC 29576-5098 (843) 390-0877 Mon - Fri 8:00 to 5:00 (843) 652-8290 Fax: (843) 390-0881 PCMH: No Fax: (843) 652-8299 Mon - Fri 8:00 to 5:00 Mon - Fri 8:30 to 5:00 PCMH: No Powers, James MD PCMH: No Provider ID: 1526480 Almeida, Nathan MD Gender: Male Abadie, Sebastian MD Provider ID: 774862 809 82nd Pkwy Provider ID: 1260987 Gender: Male Myrtle Beach, SC 29572-4607 Gender: Male Pee Dee Cardiology Associates (843) 692-1000 Georgetown Physician Associates Loris Fax: (843) 692-1109 LLC 3485 Mitchell St PCMH: No 4301 Dick Pond Rd Loris, SC 29569-2823 Myrtle Beach, SC 29588-6807 (843) 756-7029 Shea, Kevin MD (843) 652-8290 Fax: (843) 756-7033 Provider ID: 2224232 Fax: (843) 652-8299 Mon - Fri 8:00 to 5:00 Gender: Male Mon - Fri 8:30 to 5:00 PCMH: No Coastal Carolina Primary Care LLC PCMH: No 8170 Rourk St, Ste 100 Myrtle Beach, SC 29572-4127 (843) 236-1950 Fax: (843) 236-1952 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 94 38642781

Specialty Physicians Horry Internal Medicine - cont. Cicio, William MD Goodroe, Randall MD Provider ID: 2176900 Provider ID: 874319 Bach, Christopher MD Gender: Male Gender: Male Provider ID: 1408332 Cmc Cardiac Care Grand Strand Surgical Specialists Gender: Male 2376 Cypress Cir, Ste 102 199 Vlg Ctr Blvd, Ste 100 Georgetown Physician Associates Ll Conway, SC 29526-8964 Myrtle Beach, SC 29579-3589 4301 Dick Pond Rd (843) 347-8953 (843) 497-7772 Myrtle Beach, SC 29588-6807 Fax: (843) 347-0226 Fax: (843) 236-1500 (843) 652-8290 Mon - Fri 8:00 to 5:00 Grand Strand Regional Medical Fax: (843) 652-8299 PCMH: No Center Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No Ebama, Nyabilondi MD PCMH: No Provider ID: 773300 Bach, Christopher MD Gender: Female Goodroe, Randall MD Provider ID: 1408332 Lowcountry Infectious Diseases Pa Provider ID: 874319 Gender: Male 128 Pro Park Dr, Unit B Gender: Male Georgetown Physician Associates Ll Conway, SC 29526 Grand Strand Surgical Specialists 4040 Highway 17, Ste 302 (843) 449-1640 8210 Devon Ct Murrells Inlet, SC 29576-5098 Fax: (843) 449-1605 Myrtle Beach, SC 29572-4178 (843) 652-8290 Mon - Fri 8:00 to 4:30 (843) 497-7772 Fax: (843) 652-8299 PCMH: No Fax: (843) 848-7530 Mon - Fri 8:30 to 5:00 Grand Strand Regional Medical PCMH: No Edmison, Lacie MD Center Provider ID: 1737285 Mon - Thu 9:00 to 5:00 Bashall, Anthony MD Gender: Female Fri 9:00 to 4:00 Provider ID: 2315728 Mcleod Digestive Health Center PCMH: No Gender: Male Seac Grand Strand Heart Vascular Care 107 Mcleod Health Blvd, Ste 207 Haseltine, David MD 920 Doug White Dr, Ste 510 Myrtle Beach, SC 29579-4477 Provider ID: 772635 Myrtle Beach, SC 29572-4183 (843) 366-3715 Gender: Male (843) 497-7772 Fax: (843) 366-3716 Waccamaw Community Hospital Fax: (843) 848-7530 Mon - Fri 8:00 to 5:00 4070 Highway 17 Byp S Mon - Fri 8:00 to 5:00 PCMH: No Myrtle Beach, SC 29575-3350 PCMH: No (843) 652-1000 Edmison, Lacie MD Mon - Fri 9:00 to 5:00 Best, Darryl MD Provider ID: 1737285 PCMH: No Provider ID: 771397 Gender: Female Gender: Male Mcleod Digestive Health Center Hassan, Alkhatib MD South Carolina Inpatient Medicine Seac Provider ID: 2318925 A 3980 Highway 9 E, Ste 320 Gender: Male 3655 Mitchell St Little River, SC 29566-8165 Mcleod Health Loris Seacoast Loris, SC 29569 (843) 366-3715 3655 Mitchell St (843) 716-7255 Fax: (843) 366-3716 Loris, SC 29569-2827 Fax: (843) 716-7286 Mon - Fri 8:00 to 5:00 (843) 777-5240 Mon - Fri 9:00 to 5:00 PCMH: No Fax: (843) 777-5572 PCMH: No Languages: Arabic Mon - Sun 12:00 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 95 38642781

Specialty Physicians Horry Internal Medicine - cont. Kemp, Faron MD Nicol, Philip MD Provider ID: 773961 Provider ID: 772896 Hernandez, Jose MD Gender: Female Gender: Male Provider ID: 1856995 Waccamaw Community Hospital Georgetown Physician Associates Gender: Male 4070 Highway 17 Byp S LLC Strand Gi Associates Myrtle Beach, SC 29575-3350 11891 Plaza Dr 945 82nd Pkwy, Ste 3a (843) 527-7000 Murrells Inlet, SC 29576 Myrtle Beach, SC 29572-4612 Mon - Fri 9:00 to 5:00 (843) 353-0288 (843) 449-3381 PCMH: No Fax: (843) 357-9770 Fax: (843) 449-9721 Mon - Fri 8:00 to 4:30 Mon - Thu 8:00 to 5:00 PCMH: No Fri 8:00 to 1:00 Mclaughlin, Matthew DO PCMH: No Provider ID: 1554763 Gender: Male Paragas, Lamberto MD Inlet Pulmonary Critical Care And Provider ID: 1583037 Huynh, Donny MD 4057 Highway 17 Gender: Male Provider ID: 1477274 Murrells Inlt, SC 29576-5032 Tidelands Health Wound Healing Gender: Male (843) 652-4800 Cent Mcleod Oncology Hematology Fax: (843) 357-4783 4367 Riverwood Dr, Ste 140 Seacoas Mon - Thu 8:30 to 6:00 Murrells Inlt, SC 29576-4381 3980 Highway 9 E, Ste 300 PCMH: No (843) 652-8020 Little River, SC 29566-8165 Fax: (843) 652-8021 (843) 366-3891 Meyer, Stephen MD Mon - Fri 8:00 to 4:00 Fax: (843) 366-3892 PCMH: No Mon - Fri 8:00 to 5:00 Provider ID: 1794597 PCMH: No Gender: Male Coastal Carolina Primary Care LLC Patel, Nirlep MD 8170 Rourk St, Ste 100 Provider ID: 771489 Itani, Najla MD Myrtle Beach, SC 29572-4127 Gender: Male Provider ID: 2012258 (843) 236-1950 Carolina Health Specialists Gender: Female Fax: (843) 236-1952 809 82nd Pkwy Cmc Cancer Center Mon - Fri 8:00 to 5:00 Myrtle Beach, SC 29572 300 Singleton Ridge Rd PCMH: No (843) 497-5929 Conway, SC 29526-9142 Fax: (843) 497-6601 (843) 347-7111 Miara, Melissa DO Mon - Fri 9:00 to 5:00 Languages: Arabic, French PCMH: No Mon - Thu 8:00 to 5:00 Provider ID: 1923391 Fri 8:00 to 12:00 Gender: Female PCMH: No Mcleod Pulmonary & Critical Care Poland, Emily DO SE Provider ID: 1214845 3617 Casey St, Ste C Gender: Female Karavan, Mark MD Loris, SC 29569-2981 Georgetown Physician Associates Provider ID: 204384 (843) 716-7911 LLC Gender: Male Fax: (843) 716-7918 4040 Highway 17, Ste 3602 920 Doug White Dr Mon - Fri 8:00 to 5:00 Murrells Inlet, SC 29576 Myrtle Beach, SC 29572 PCMH: No (843) 235-3131 (843) 497-7772 Fax: (843) 237-9797 Grand Strand Regional Medical Nagabandi, Shashikanth MD Mon - Fri 8:30 to 5:00 Center PCMH: No PCMH: No Provider ID: 2271942 Gender: Male Grand Strand Heart Vascular Care 920 Doug White Dr, Ste 540 Myrtle Beach, SC 29572-4180 (843) 497-7772 Fax: (843) 497-7772 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 96 38642781

Specialty Physicians Horry Internal Medicine - cont. Santiago, Kenneth MD Terchek, Melissa MD Provider ID: 990540 Provider ID: 2189223 Poland, Emily DO Gender: Male Gender: Female Provider ID: 1214845 Kenneth A Santiago Md Carolina Rheumatology & Neuro- Gender: Female 300 Singleton Ridge Rd logy A Georgetown Physician Associates Conway, SC 29526-9142 8220 Nigels Dr LLC (843) 347-7111 Myrtle Beach, SC 29572-4125 4301 Dick Pond Rd Fax: (843) 234-6722 (843) 692-0968 Myrtle Beach, SC 29588-6807 Languages: Spanish Fax: (843) 692-2688 (843) 235-3131 Mon - Fri 9:00 to 5:00 Tue, Thu 8:00 to 4:00 Fax: (843) 237-9797 PCMH: No PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No Subnani, Kishore MD Interventional Cardiology Provider ID: 2160587 Powers, James MD Gender: Male Brady, Stephen MD Provider ID: 1526480 Mcleod Cardiology Assoc Myrtle Provider ID: 1990001 Gender: Male 107 Mcleod Health Blvd, Ste 202 Gender: Male Strand Infectious Disease PC Loris, SC 29579 Cmc Cardiac Care 831 82nd Pkwy (843) 839-1201 2376 Cypress Cir, Ste 102 Myrtle Beach, SC 29572-4607 Fax: (843) 839-1202 Conway, SC 29526-8964 (843) 839-0135 Mon - Fri 8:00 to 5:00 (843) 347-8953 Fax: (843) 449-2333 PCMH: No Fax: (843) 347-0226 Mon - Fri 8:00 to 5:00 Mon - Fri 7:30 to 5:00 PCMH: No PCMH: No Swift, Catherine MD Provider ID: 1179844 Powers, James MD Gender: Female Chaubey, Vinod MD Provider ID: 1526480 Georgetown Physician Associates Provider ID: 2321950 Gender: Male LLC Gender: Male 809 82nd Pkwy 1220 21st Ave N Cmc Cardiac Care Myrtle Beach, SC 29572-4607 Myrtle Beach, SC 29577-7401 2376 Cypress Cir, Ste 102 (843) 692-1000 (847) 365-2830 Conway, SC 29526-8964 Fax: (843) 692-1109 Fax: (843) 652-8301 (843) 347-8953 PCMH: No Mon - Fri 9:00 to 5:00 Fax: (843) 347-0226 PCMH: No Mon - Thu 8:00 to 5:00 Raynor, Kathleen MD Fri 8:00 to 12:00 PCMH: No Provider ID: 1323565 Swift, Catherine MD Gender: Female Provider ID: 1179844 Cardiology Gastroenterology Gender: Female Hadstate, James MD Associa Georgetown Physician Associates Provider ID: 1312741 945 82nd Pkwy, Ste 3 LLC Gender: Male Myrtle Beach, SC 29572 4181 Highway 17 Grand Strand Gme- Cardiology (843) 449-3381 Murrells Inlet, SC 29576-5019 199 Village Center Blvd, Ste 100 Fax: (843) 839-0275 (843) 652-3600 Myrtle Beach, SC 29579 Mon - Thu 8:00 to 5:00 Fax: (843) 652-3602 (843) 497-7772 Fri 8:00 to 1:00 Mon - Thu 8:00 to 5:00 Fax: (843) 236-1500 PCMH: No Fri 8:00 to 6:30 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 97 38642781

Specialty Physicians Horry Interventional Cardiology - cont. Nephrology Po, Christopher MD Provider ID: 774924 Hadstate, James MD Balachandra, Sivanthan MD Gender: Male Provider ID: 1312741 Provider ID: 775084 Mcleod Nephrology Seacoast Gender: Male Gender: Male 3617 Casey St, Ste C Grand Strand Surgical Specialists Coastal Kidney Center Loris, SC 29569-2981 8210 Devon Ct 1151 44th Ave N, Ste A (843) 716-7613 Myrtle Beach, SC 29572 Myrtle Beach, SC 29577-5756 Fax: (843) 716-7918 (843) 497-7772 (843) 497-7275 Mon - Thu 8:00 to 5:00 Fax: (843) 848-7530 Fax: (843) 497-7110 Fri 8:00 to 1:00 Mon - Thu 8:30 to 5:00 Wed 11:00 to 5:00 PCMH: No Fri 8:30 to 4:00 PCMH: No PCMH: No Po, Christopher MD Balachandra, Sivanthan MD Provider ID: 774924 Medical Oncology Provider ID: 775084 Gender: Male Gender: Male Mcleod Nephrology Seacoast Haughton, Michael MD Coastal Kidney Center Provider ID: 1238810 3980 Highway 9 E, Ste 240 834 Farrar Dr Little River, SC 29566-8164 Gender: Male Conway, SC 29526 Georgetown Physician Associates (843) 716-7163 (843) 347-9487 Fax: (843) 716-7918 LLC Fax: (843) 347-9574 1220 21st Ave N Mon - Fri 8:00 to 5:00 Mon - Tue, Fri 11:00 to 5:00 PCMH: No Myrtle Beach, SC 29577-7401 PCMH: No (843) 652-8300 Fax: (843) 652-8301 Neurology Mon - Fri 9:00 to 5:00 Elms, John MD PCMH: No Provider ID: 775711 Almidani, Mazen MD Gender: Male Provider ID: 2318889 Coastal Kidney Center Pa Gender: Male Haughton, Michael MD 1151 44th Ave N, Ste A Mcleod Health Loris Seacoast Provider ID: 1238810 Myrtle Beach, SC 29577-5756 3655 Mitchell St Gender: Male (843) 497-7275 Loris, SC 29569-2827 Georgetown Physician Associates Fax: (843) 497-7110 (843) 777-5240 LLC Grand Strand Regional Medical Fax: (843) 777-5572 4181 Highway 17 Center Mon - Sun 12:00 to 12:00 Murrells Inlet, SC 29576-5019 Mcleod Loris Seacoast Ho PCMH: No (843) 652-3600 Conway Medical Center Fax: (843) 652-3602 Mon - Wed, Fri 12:00 to 5:00 Bangco, Mario MD Mon - Fri 9:00 to 5:00 PCMH: No PCMH: No Provider ID: 1081883 Gender: Male Elms, John MD Cmc Neurology Paudel, Vijay MD Provider ID: 775711 124 Professional Park Dr Provider ID: 1989883 Gender: Male Conway, SC 29526 Gender: Male Coastal Kidney Center Pa (843) 347-4473 Associated Medical Specialists Pa 834 Farrar Dr Fax: (843) 234-8951 8121 Rourk St Conway, SC 29526 Mon - Thu 8:00 to 5:00 Myrtle Beach, SC 29572-4128 (843) 347-9487 Fri 8:00 to 1:00 (843) 692-5000 Fax: (843) 347-9574 PCMH: No Fax: (843) 295-5010 Grand Strand Regional Medical Mon - Thu 7:30 to 5:00 Center Fri 7:30 to 3:00 Mcleod Loris Seacoast Ho Sat - Sun 8:30 to 12:00 Conway Medical Center PCMH: No Mon - Tue 12:00 to 5:00 Wed, Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 98 38642781

Specialty Physicians Horry Neurology - cont. Khishchenko, Natan MD Newman, Richard MD Provider ID: 2318929 Provider ID: 2318967 Colongarcia, Patricia MD Gender: Male Gender: Male Provider ID: 2313069 Mcleod Health Loris Seacoast Mcleod Health Loris Seacoast Gender: Female 3655 Mitchell St 3655 Mitchell St Mcleod Health Loris Seacoast Loris, SC 29569-2827 Loris, SC 29569-2827 3655 Mitchell St (843) 777-5240 (843) 777-5240 Loris, SC 29569-2827 Fax: (843) 777-5572 Fax: (843) 777-5572 (843) 716-7000 Mon - Sun 12:00 to 12:00 Mon - Sun 12:00 to 12:00 Fax: (843) 320-8322 PCMH: No PCMH: No Mon - Sun 12:00 to 12:00 PCMH: No Mccaffrey, Michael MD Null, Elizabeth MD Provider ID: 1202016 Provider ID: 2318968 Coni, Robert DO Gender: Male Gender: Female Provider ID: 1244383 Mcleod Neurology Carolina Forest Mcleod Health Loris Seacoast Gender: Male 107 Mcleod Health Blvd, Ste 102 3655 Mitchell St Grand Strand Specialty Associates Myrtle Beach, SC 29579-4477 Loris, SC 29569-2827 849 82nd Pkwy (843) 646-8040 (843) 777-5240 Myrtle Beach, SC 29572 Fax: (843) 777-7005 Fax: (843) 777-5572 (843) 449-2336 Mon - Fri 8:00 to 5:00 Mon - Sun 12:00 to 12:00 Fax: (843) 497-0625 PCMH: No PCMH: No Mon - Thu 8:00 to 5:00 Fri 8:00 to 3:00 PCMH: No Mccaffrey, Michael MD Sandoz, George MD Provider ID: 1202016 Provider ID: 1224713 Gender: Male Gender: Male Figueroa Garcia, Alberto MD Mcleod Neurology Seacoast Cmc Neurology 3710 Mishoe St 124 Professional Park Dr Provider ID: 2309820 Loris, SC 29569-2822 Conway, SC 29526 Gender: Male (843) 716-8900 (843) 347-4473 Mcleod Health Loris Seacoast Fax: (843) 716-2273 Fax: (843) 234-8951 3655 Mitchell St Mon - Fri 8:00 to 5:00 Languages: Portuguese, Spanish Loris, SC 29569-2827 PCMH: No Mon - Thu 8:30 to 5:00 (843) 716-7000 Fri 8:30 to 1:00 Fax: (843) 320-8322 PCMH: No Mon - Sun 12:00 to 12:00 Mcdonald, Mark MD PCMH: No Provider ID: 2309837 Gender: Male Sandoz, George MD Mcleod Health Loris Seacoast Provider ID: 1224713 Grinman, Mark MD 3655 Mitchell St Gender: Male Provider ID: 1210239 Loris, SC 29569-2827 Cmc Neurology Gender: Male (843) 716-7000 2361 Cypress Cir Grand Strand Specialty Associates Fax: (843) 320-8322 Conway, SC 29526 849 82nd Pkwy Mon - Sun 12:00 to 12:00 (843) 347-7291 Myrtle Beach, SC 29572 PCMH: No Fax: (843) 347-0139 (843) 449-2336 Languages: Portuguese, Spanish Fax: (843) 497-6351 Mendelson, Joshua MD Mon - Thu 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fri 8:00 to 12:00 PCMH: No Provider ID: 2318945 Gender: Male PCMH: No Mcleod Health Loris Seacoast 3655 Mitchell St Loris, SC 29569-2827 (843) 777-5240 Fax: (843) 777-5572 Mon - Sun 12:00 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 99 38642781

Specialty Physicians Horry Neurology - cont. Vemuri, Praveen MD Neurosurgery Provider ID: 1648856 Sandoz, George MD Gender: Male Bailey, Byron MD Provider ID: 1224713 Cmc Neurology Provider ID: 1191173 Gender: Male 124 Professional Park Dr Gender: Male Conway Medical Center Surgical Conway, SC 29526-9260 Roper St Francis Physician Partners Asso (843) 347-4473 4823 Hwy 17 N, Ste B 4367 Riverwood Dr, Ste 210a Fax: (843) 234-8951 Murrells Inlet, SC 29576-5037 Conway, SC 29526 Mon - Thu 8:00 to 5:00 (843) 723-8823 (843) 347-7291 Fri 8:00 to 1:00 Fax: (843) 766-6551 Fax: (843) 347-0139 PCMH: No Mon - Fri 9:00 to 5:00 Languages: Portuguese, Spanish PCMH: No Mon - Thu 8:00 to 5:00 Vidgop, Yelana MD Fri 8:00 to 12:00 Cheatle, Joseph MD PCMH: No Provider ID: 2309865 Gender: Female Provider ID: 2022728 Mcleod Health Loris Seacoast Gender: Male Shissias, Charles MD 3655 Mitchell St Grand Strand Specialty Associates Provider ID: 2287554 Loris, SC 29569-2827 849 82nd Pkwy Gender: Male (843) 716-7000 Myrtle Beach, SC 29572-4614 Grand Strand Behavioral Health Fax: (843) 320-8322 (843) 449-2336 5050 Highway 17 Byp S Mon - Sun 12:00 to 12:00 Fax: (849) 497-0625 Myrtle Beach, SC 29588-4500 PCMH: No Mon - Fri 8:00 to 5:00 (843) 839-6090 PCMH: No Fax: (843) 497-8305 Worthington, Ward MD Mon - Fri 8:00 to 5:00 Cuddy, Brian MD PCMH: No Provider ID: 1191155 Gender: Male Provider ID: 1190713 Roper St Francis Physician Partners Roper St Francis Physician Partners Spencer, Olinda MD 4823 Hwy 17 N, Ste B 4823 Hwy 17 N, Ste B Provider ID: 1604474 Murrells Inlet, SC 29576-5037 Murrells Inlet, SC 29576-5037 Gender: Female (843) 723-8823 (843) 723-8823 Mcleod Neurology Carolina Forest Fax: (843) 766-6551 Fax: (843) 766-6551 107 Mcleod Health Blvd, Ste 102 Mon - Fri 9:00 to 5:00 Mon - Fri 9:00 to 5:00 Myrtle Beach, SC 29579-4477 PCMH: No PCMH: No (843) 646-8040 Fax: (843) 777-7005 Mon - Fri 8:00 to 5:00 Worthington, Ward MD Eggart, Malcolm MD PCMH: No Provider ID: 1191155 Provider ID: 1560684 Gender: Male Gender: Male Roper St. Francis Physician Partner Musc Health Partners Vega, Jose MD 4835 Hwy 17 N Bypass, Ste B 4040 Highway 17, Ste 306 Provider ID: 2309880 Murrells Inlet, SC 29576-5037 Murrells Inlet, SC 29576-5098 Gender: Male (843) 723-8823 (843) 357-0083 Mcleod Health Loris Seacoast Fax: (843) 766-6551 Fax: (843) 357-0088 3655 Mitchell St Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 Loris, SC 29569-2827 PCMH: No PCMH: No (843) 716-7000 Fax: (843) 320-8322 Mon - Sun 12:00 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 100 38642781

Specialty Physicians Horry Neurosurgery - cont. Smith, James MD Billue, David MD Provider ID: 2287683 Provider ID: 2022658 Giddens, Eugene MD Gender: Male Gender: Male Provider ID: 812979 Grand Strand Spine Neurology Coastal Carolina Primary Care LLC Gender: Male 920 Doug White Dr, Ste 460 839 82nd Parkway Grand Strand Speciality Associates Myrtle Beach, SC 29572-4182 Myrtle Beach, SC 29572 849 82nd Pkwy (843) 449-2336 (843) 236-1950 Myrtle Beach, SC 29572-4614 Fax: (843) 497-0625 Fax: (843) 236-1952 (843) 497-6348 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 497-0625 PCMH: No PCMH: No Grand Strand Regional Medical Center Mon - Thu 8:00 to 5:00 Steichen, John MD Carter, Xaviera MD Fri 8:00 to 3:00 Provider ID: 1191096 Provider ID: 901889 PCMH: No Gender: Male Gender: Female Roper St. Francis Physician Partner Tidelands Health Womens Center 4835 Hwy 17 N Bypass, Ste B 4320 Holmestown Rd Khoury, George MD Murrells Inlet, SC 29576-5037 Myrtle Beach, SC 29588-7837 Provider ID: 1190883 (843) 723-8823 (843) 652-8440 Gender: Male Fax: (843) 766-6551 Fax: (843) 652-8441 Roper St Francis Physician Partners Mon - Fri 9:00 to 5:00 Mon - Fri 9:00 to 5:00 4823 Hwy 17 N, Ste B PCMH: No PCMH: No Murrells Inlet, SC 29576-5037 (843) 723-8823 Fax: (843) 766-6551 Stuart, Robert MD Dunn, Kathleen MD Mon - Fri 9:00 to 5:00 Provider ID: 1191097 Provider ID: 2206534 PCMH: No Gender: Male Gender: Female Roper St Francis Physician Partners Cmc Women's Health Conway 4823 Hwy 17 N, Ste B 2376 Cypress Cir, Ste 200 Pacult, Arthur MD Murrells Inlet, SC 29576-5037 Conway, SC 29526-8994 Provider ID: 1191014 (843) 723-8823 (843) 347-7216 Gender: Male Fax: (843) 766-6551 Fax: (843) 347-7218 Roper St Francis Physician Partners Mon - Fri 9:00 to 5:00 Mon - Thu 8:30 to 5:00 4823 Hwy 17 N, Ste B PCMH: No Fri 8:30 to 12:30 Murrells Inlet, SC 29576-5037 PCMH: No (843) 723-8823 Fax: (843) 766-6551 Obstetrics/Gynecology Eames, Lacey DO Mon - Fri 9:00 to 5:00 Alo, Olubunmi MD PCMH: No Provider ID: 2322254 Provider ID: 1232823 Gender: Female Gender: Female Cmc Women's Health Conway Pacult, Arthur MD Cmc Women's Health Towne 2376 Cypress Cir, Ste 200 Provider ID: 1191014 Center Conway, SC 29526-8994 Gender: Male 5010 Carolina Forest Blvd (843) 347-7216 Roper St. Francis Physician Partner Myrtle Beach, SC 29579 Fax: (843) 347-7218 4835 Hwy 17 N Bypass, Ste B (843) 903-1010 Mon - Thu 8:30 to 5:00 Murrells Inlet, SC 29576-5037 Fax: (843) 903-1015 Fri 8:30 to 12:30 (843) 723-8823 Mon - Tue 9:00 to 5:00 PCMH: No Fax: (843) 766-6551 Wed - Thu 9:00 to 5:30 Mon - Fri 9:00 to 5:00 Fri 9:00 to 1:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 101 38642781

Specialty Physicians Horry Obstetrics/Gynecology - cont. King, Merritt MD Kolb, Cynthia MD Provider ID: 938098 Provider ID: 774288 Grady, Cynthia MD Gender: Male Gender: Female Provider ID: 1981735 Mcleod Ob Gyn Seacoast Mcleod Ob/Gyn Seacoast Gender: Female 3617 Casey St, Ste A 3980 Highway 9 E, Ste 110 Health Care Partners Of South Loris, SC 29569-2981 Little River, SC 29566-8163 Carol (843) 756-7090 (843) 399-3100 1608 Main St Fax: (843) 756-0043 Fax: (843) 399-1099 Conway, SC 29526-3572 Mcleod Loris Seacoast Ho Mon - Fri 9:00 to 5:00 (843) 248-4700 Mon - Fri 8:00 to 5:00 PCMH: No Mon - Sat 8:00 to 5:00 PCMH: No PCMH: No Lasry, Valerie MD King, Merritt MD Provider ID: 1603506 Harford, Janelle MD Provider ID: 938098 Gender: Female Provider ID: 1611452 Gender: Male Carolina Ob/Gyn Gender: Female Mcleod Ob Gyn Seacoast 4017 Highway 17 Coastal Carolina OBGYN 3980 Highway 9 E, Ste 110 Murrells Inlt, SC 29576-5032 620 Singleton Ridge Rd Little River, SC 29566-8163 (843) 651-6525 Conway, SC 29526-9154 (843) 399-3100 Fax: (843) 357-0768 (843) 349-0100 Fax: (843) 399-1099 Mon - Fri 9:00 to 5:00 Fax: (843) 349-0104 Mcleod Loris Seacoast Ho PCMH: No Mon - Thu 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fri 8:00 to 12:00 PCMH: No PCMH: No Martinez, Eduardo MD Provider ID: 1706525 Koike, Jun MD Gender: Male Heineck, Robert MD Provider ID: 1720902 Georgetown Physician Associates Ll Provider ID: 1767960 Gender: Male 4320 Holmestown Rd Gender: Male Health Care Partners Of South Myrtle Beach, SC 29588-7837 Georgetown Physician Associates Ll Carol (843) 652-8440 4320 Holmestown Rd 1608 Main St Fax: (843) 652-8441 Myrtle Beach, SC 29588 Conway, SC 29526-3572 Languages: Spanish (843) 546-3132 (843) 248-4700 Mon - Fri 9:00 to 5:00 Fax: (843) 546-2268 Mon - Thu 8:00 to 5:00 PCMH: No Mon - Wed, Fri 9:00 to 5:00 Fri 8:00 to 12:00 Thu 9:00 to 4:00 PCMH: No PCMH: No Maselli, Lisa MD Provider ID: 1603510 Kolb, Cynthia MD Gender: Female Keisler, Lydia MD Provider ID: 774288 Carolina Ob/Gyn Provider ID: 1853612 Gender: Female 4017 Highway 17 Gender: Female Mcleod Ob/Gyn Seacoast Murrells Inlt, SC 29576-5032 Elite Pain Management LLC 3617 Casey Street (843) 651-6525 8212 Devon Ct Loris, SC 29569-2981 Fax: (843) 357-0768 Myrtle Beach, SC 29572-4178 (843) 399-3100 Mon - Fri 9:00 to 5:00 (843) 273-0376 Fax: (843) 399-1099 PCMH: No Fax: (843) 273-4516 Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 102 38642781

Specialty Physicians Horry Obstetrics/Gynecology - cont. Richmond, Gayle MD Wotherspoon, Barbara MD Provider ID: 1606608 Provider ID: 1712770 Mccauley, Chris MD Gender: Female Gender: Female Provider ID: 772306 Carolina Ob Gyn Elite Pain Management LLC Gender: Male 4017 Highway 17 4237 River Hills Dr, Ste 170 North Strand OBGYN Murrells Inlt, SC 29576-5032 Little River, SC 29566-6446 3617 Casey St, Ste A (843) 651-6525 (843) 273-0376 Loris, SC 29569-2981 Fax: (843) 357-0768 Fax: (843) 273-4516 (843) 756-7090 Mon - Fri 9:00 to 5:00 Mon - Fri 9:00 to 5:30 Fax: (843) 756-0043 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Schindler, Joycelyn MD Ophthalmology Provider ID: 970568 Mccauley, Chris MD Gender: Female Chaum, Edward MD Provider ID: 772306 Mcleod Ob Gyn Seacoast Provider ID: 1337348 Gender: Male 3617 Casey St, Ste A Gender: Male North Strand OBGYN Loris, SC 29569-2981 Little River Medical Center Inc 3980 Highway 9 E, Ste 110 (843) 756-7090 3236 Holmestown Rd, Ste E1 Little River, SC 29566 Fax: (843) 756-0043 Myrtle Beach, SC 29588 (843) 399-1099 Mcleod Loris Seacoast Ho (843) 663-8000 Fax: (843) 756-0043 Languages: Tagalog Fax: (843) 663-8092 PCMH: No Mon - Fri 8:00 to 5:00 Mon - Fri 8:30 to 5:30 PCMH: No PCMH: No Mccauley, Chris MD Provider ID: 818196 Schindler, Joycelyn MD Greene, Howard MD Gender: Male Provider ID: 970568 Provider ID: 1899332 Mcleod Ob Gyn Seacoast Gender: Female Gender: Male 3980 Highway 9 E, Ste 110 Mcleod OBGYN Seacoast Clemson Eye Pa Little River, SC 29566-8163 3980 Highway 9 E, Ste 110 3819 Main St (843) 399-3100 Little River, SC 29566 Loris, SC 29569-3017 Fax: (843) 399-1099 (843) 399-3100 (864) 654-6706 Mcleod Loris Seacoast Ho Fax: (843) 399-1099 Fax: (864) 343-2074 Mon - Thu 9:00 to 5:00 Mcleod Loris Seacoast Ho Mon - Fri 8:00 to 5:30 Fri 9:00 to 1:00 Languages: Tagalog PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Marchase, Nicholas MD Mccauley, Chris MD Provider ID: 2226599 Provider ID: 818196 Washington, Dode MD Gender: Male Gender: Male Provider ID: 772441 South Carolina Retina Institute LLC Mcleod OBGYN Seacoast Gender: Female 1404 Main St 3617 Casey St, Ste A Coastal Carolina OBGYN Conway, SC 29526-3567 Loris, SC 29569-2981 620 Singleton Ridge Rd (843) 488-1100 (843) 756-7090 Conway, SC 29526 Fax: (843) 488-7701 Fax: (843) 756-0043 (843) 349-0100 Mon - Thu 9:00 to 4:00 Mcleod Loris Seacoast Ho Fax: (843) 349-0104 Fri 9:00 to 12:00 Mon - Thu 8:00 to 5:00 Mon - Fri 9:00 to 5:00 PCMH: No Fri 8:00 to 1:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 103 38642781

Specialty Physicians Horry Ophthalmology - cont. Sandoz, George MD Optician Provider ID: 1224713 Phillips, Stephen MD Gender: Male Coastal Vision Center Inc Provider ID: 771734 Conway Medical Center Surgical Provider ID: TPVCOAS02-01 Gender: Male Asso 1651 Glenns Bay Road East Coast Retina 4367 Riverwood Dr, Ste 210a Myrtle Beach, SC 29575 8609 Montague Ln Conway, SC 29526 (843) 650-2400 Myrtle Beach, SC 29588 (843) 347-7291 Fax: (843) 650-2525 (843) 215-3363 Fax: (843) 347-0139 Mon - Fri 8:00 to 5:30 Fax: (843) 215-7201 Languages: Portuguese, Spanish PCMH: No Mon, Wed - Thu 7:00 to 3:00 Mon - Thu 8:00 to 5:00 Tue 9:00 to 5:00 Fri 8:00 to 12:00 Eyemart Express LLC Fri 7:00 to 1:00 PCMH: No Provider ID: TPVEYEM20-08 PCMH: No 1370 South Commons Drive, Suite Seltzer, Samuel MD 102 Proctor, Charles MD Provider ID: 1899328 Myrtle Beach, SC 29588 Provider ID: TPVPROC03-01 Gender: Male (843) 353-6751 Gender: Male Clemson Eye Pa Fax: (843) 650-9695 Vaught Eye Associates Pa 3819 Main St Mon - Fri 9:00 to 7:00 1406 Main Street Loris, SC 29569 Sat 9:00 to 5:00 Conway, SC 29526 (843) 664-9393 PCMH: No (843) 488-2020 Fax: (843) 664-2301 Fax: (843) 488-9659 Mon - Fri 8:00 to 4:30 Mgb Eyes Inc Mon - Tue, Thu 8:00 to 5:00 PCMH: No Provider ID: TPVCRAV02-01 PCMH: No 350 Seaboard Street Seltzer, Samuel MD Myrtle Beach, SC 29577 Sandoz, George MD Provider ID: 770236 (843) 839-2233 Provider ID: 1224713 Gender: Male Fax: (843) 839-0137 Gender: Male Carolinas Centers For Sight PC Mon - Fri 9:00 to 6:00 Cmc Neurology 3819 Main St Sat 10:00 to 4:00 124 Professional Park Dr Loris, SC 29569-3017 PCMH: No Conway, SC 29526 (843) 664-9393 (843) 347-4473 Fax: (843) 662-9261 Walmart Vision Center Fax: (843) 234-8951 Mon - Fri 8:00 to 4:30 Provider ID: TPVWALM40-02 Languages: Portuguese, Spanish PCMH: No 10820 North Kings Highway, Mon - Thu 8:30 to 5:00 Walmart Vision Center 643 Fri 8:30 to 1:00 Myrtle Beach, SC 29572 PCMH: No Vasuki, Nagavivek MD Provider ID: 1899330 (843) 449-4626 Gender: Male Fax: (843) 692-0409 Sandoz, George MD Clemson Eye Pa Mon - Fri 9:00 to 7:00 Provider ID: 1224713 3819 Main St Sat 9:00 to 6:00 Gender: Male Loris, SC 29569-3017 PCMH: No Cmc Neurology (864) 654-6706 2361 Cypress Cir Fax: (864) 343-2074 Walmart Vision Center Conway, SC 29526 Mon - Fri 8:00 to 5:30 Provider ID: TPVWALM40-24 (843) 347-7291 PCMH: No 2709 Church Street Suite A, Fax: (843) 347-0139 Walmart Vision Center 586 Languages: Portuguese, Spanish Conway, SC 29526 Mon - Thu 8:00 to 5:00 (843) 365-0739 Fri 8:00 to 12:00 Fax: (843) 365-0751 PCMH: No Mon - Fri 9:00 to 6:00 Sat 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 104 38642781

Specialty Physicians Horry Optician - cont. Optometry Bittner, Benjamin OD Provider ID: TPVBITT09-03 Walmart Vision Center Allouch, Fouad OD Gender: Male Provider ID: TPVWALM40-38 Provider ID: TPVALLO04-02 Benjamin J Bittner Od Inc 541 Seaboard Street, Walmart Gender: Male 1946 Mr Joe White Avenue Vision Center 2712 Allouch Optometric PC Myrtle Beach, SC 29577 Myrtle Beach, SC 29577 2703 North Kings Highway (843) 443-6000 (843) 448-5791 Myrtle Beach, SC 29577 Fax: (843) 443-6002 Fax: (843) 448-2992 (843) 448-1596 Mon, Wed - Thu 10:00 to 5:30 Mon - Fri 9:00 to 7:00 Fax: (843) 448-4793 PCMH: No Sat 9:00 to 6:00 Mon - Fri 9:00 to 5:00 Sun 12:00 to 5:00 Sat 9:00 to 3:00 PCMH: No PCMH: No Bittner, Benjamin OD Provider ID: TPVBITT09-04 Gender: Male Walmart Vision Center Allouch, Fouad OD Benjamin J Bittner Od Inc Provider ID: TPVWALM40-40 Provider ID: TPVALLO04-03 9403 Highway 707, Unit C 550 Highway 17 North, Walmart Gender: Male Myrtle Beach, SC 29588 Vision Center 5087 Allouch Optometric PC (843) 443-6000 North Myrtle Beach, SC 29582 706 Sea Mountain Highway Fax: (843) 668-2878 (843) 281-8073 North Myrtle Beach, SC 29582 Mon - Thu 9:00 to 5:00 Fax: (843) 281-8084 (843) 249-8440 PCMH: No Mon - Fri 9:00 to 7:00 Fax: (843) 280-5388 Sat 9:00 to 5:00 Mon - Fri 9:00 to 5:00 PCMH: No PCMH: No Bodofsky, Gary OD Provider ID: TPVBODO01-01 Gender: Male Walmart Vision Center Bittner, Benjamin OD Gary Bodofsky Provider ID: TPVWALM40-50 Provider ID: TPVBITT09-01 1006 Church Street, Suite A 2751 Beaver Run Boulevard, Gender: Male Conway, SC 29526 Walmart Vision Center 574 Benjamin J Bittner Od Inc (843) 248-5513 Myrtle Beach, SC 29575 541 Seaboard Street Fax: (843) 248-2733 (843) 215-3694 Myrtle Beach, SC 29577 Mon - Tue, Thu - Fri 8:30 to 5:00 Fax: (843) 215-3738 (843) 444-8280 Wed 8:30 to 12:30 Mon - Fri 9:00 to 7:00 Fax: (843) 668-2878 PCMH: No Sat 9:00 to 6:00 Mon - Fri 8:30 to 5:00 Sun 12:00 to 5:00 PCMH: No PCMH: No Bodofsky, Gary OD Provider ID: TPVBODO01-02 Bittner, Benjamin OD Gender: Male Walmart Vision Center Provider ID: TPVBITT09-02 Gary Bodofsky Provider ID: TPVWALM40-74 Gender: Male 2014 Highway 17 North 545 Garden City Connector, Benjamin J Bittner Od Inc Surfside Beach, SC 29575 Walmart Vision Center 5705 10820 Kings Road (843) 238-2020 Murrells Inlet, SC 29576 Myrtle Beach, SC 29572 Fax: (843) 238-4443 (843) 357-0382 (843) 444-8280 Mon - Tue, Thu 8:30 to 5:00 Fax: (843) 357-0376 Fax: (843) 668-2878 Wed 8:30 to 1:00 Mon - Fri 9:00 to 7:00 Fri 8:30 to 5:00 Fri 10:00 to 3:30 Sat 9:00 to 5:00 PCMH: No PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 105 38642781

Specialty Physicians Horry Optometry - cont. Dean, Mark OD Kozel-Diamond, Sandra OD Provider ID: TPVDEAN08-01 Provider ID: TPVKOZE01-02 Caugh, Kurtis OD Gender: Male Gender: Female Provider ID: TPVCAUG01-01 Socastee Eye Clinic Eye Associates Of Little River LLC Gender: Male 4885 Socastee Boulevard 3700 Sawtell Road, Suite B Kurtis Caugh Od Myrtle Beach, SC 29588 Little River, SC 29566 550 Highway 17 North (843) 293-8101 (843) 390-0058 North Myrtle Beach, SC 29582 Fax: (843) 293-8102 Fax: (843) 390-0999 (843) 281-8181 Mon - Fri 8:30 to 5:30 Mon - Thu 8:30 to 5:00 Fax: (843) 281-9009 PCMH: No Fri 8:30 to 1:00 Mon - Tue, Thu - Fri 9:00 to 5:00 PCMH: No Wed 10:00 to 6:00 PCMH: No Dean, Mark OD Provider ID: TPVDEAN08-02 Lee, Amanda OD Gender: Male Provider ID: TPVLEE97-02 Coker, James OD Mark T Dean Od Gender: Female Provider ID: TPVCOKE02-03 4886 Socastee Boulevard Seaside Eye Associates Pa Gender: Male Myrtle Beach, SC 29588 109 Finnegan Court Coastal Vision Center Inc (843) 293-1555 Myrtle Beach, SC 29579 1651 Glenns Bay Road Fax: (866) 223-6207 (843) 903-0949 Myrtle Beach, SC 29575 Mon - Thu 9:00 to 5:00 Fax: (843) 903-1101 (843) 650-2400 PCMH: No Mon - Fri 9:00 to 5:00 Fax: (843) 650-2525 Sat 9:00 to 2:00 Mon - Fri 8:00 to 5:30 PCMH: No PCMH: No Diamond, Jason OD Provider ID: TPVDIAM02-03 Gender: Male Merhi, Eva OD Collette, David OD Eye Associates Of Little River LLC Provider ID: 1083097 Provider ID: TPVCOLL12-04 3700 Sawtell Road, Suite B Gender: Female Gender: Male Little River, SC 29566 Optic Gallery LLC Benjamin J Bittner Od Inc (843) 390-0058 4036 River Oaks Dr, Ste B-8 1946 Mr Joe White Avenue Fax: (843) 390-0999 Myrtle Beach, SC 29579-6695 Myrtle Beach, SC 29577 Mon - Thu 8:30 to 5:00 (843) 236-2500 (843) 443-6000 Fri 8:30 to 1:00 Fax: (843) 236-2575 Fax: (843) 443-6002 PCMH: No Languages: Spanish Mon, Wed - Thu 9:30 to 5:30 Mon - Fri 9:00 to 5:00 PCMH: No Graham, Lauri OD Sat 10:00 to 4:00 Provider ID: TPVGRAH04-03 PCMH: No Creson, Stuart OD Gender: Female Provider ID: TPVCRES02-01 Distinctive Eyewear Vision Center Merhi, Eva OD Gender: Male 1370 South Commons Drive, Suite Provider ID: TPVMERH01-02 Stuart Creson 102 Gender: Female 2751 Beaver Run Boulevard Myrtle Beach, SC 29588 Optic Gallery LLC Myrtle Beach, SC 29575 (843) 213-1201 4036 River Oaks Drive, Suite B 8 (843) 215-0101 Fax: (843) 650-9697 Myrtle Beach, SC 29579 Fax: (843) 215-0113 Mon - Tue, Thu - Fri 9:30 to 5:30 (843) 236-2500 Mon - Sat 9:00 to 5:00 Sat 9:30 to 2:00 Fax: (843) 236-2575 PCMH: No PCMH: No Mon - Thu 9:00 to 5:00 Fri 9:00 to 4:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 106 38642781

Specialty Physicians Horry Optometry - cont. Siegmund, Kelle OD Vaught, James OD Provider ID: TPVSIEG14-01 Provider ID: 934664 Mills, Michael OD Gender: Female Gender: Male Provider ID: TPVMILL52-01 Bergelt Optometric LLC Vaught Eye Associates Gender: Male 2709 Church Street, Suite A 1406 Main St Dr Michael L Mills Pa Conway, SC 29526 Conway, SC 29526-3567 3420 Broad Street (843) 369-3937 (843) 488-2020 Loris, SC 29569 Fax: (843) 432-3189 Fax: (843) 488-9659 (843) 756-6919 Mon - Fri 9:00 to 5:00 Languages: Spanish Fax: (843) 756-6900 PCMH: No Mon - Fri 8:00 to 6:00 Mon - Tue, Thu 8:00 to 5:00 Sat 8:00 to 12:00 Fri 8:00 to 1:00 PCMH: No PCMH: No Smith, Franklin OD Provider ID: TPVSMIT41-01 Gender: Male Vaught, James OD Poole, R Gary OD Fraklin N Smith Od Provider ID: 952283 Provider ID: TPVPOOL01-03 4221 Mayfair Street, Smith Eye Gender: Male Gender: Male Associates Vaught Eye Associates Bergelt Optometric LLC Myrtle Beach, SC 29577 1406 Main St 2709 Church Street (843) 448-6630 Conway, SC 29526-3567 Conway, SC 29526 Fax: (843) 448-5567 (843) 488-2020 (843) 369-3937 Mon - Thu 7:30 to 5:00 Fax: (843) 488-9659 Fax: (843) 369-3337 PCMH: No Languages: Spanish Mon - Sat 9:00 to 5:00 Mon - Fri 8:00 to 6:00 PCMH: No Thomas, Shawn OD Sat 8:00 to 12:00 Provider ID: TPVTHOM30-05 PCMH: No Poole, R Gary OD Gender: Male Provider ID: TPVPOOL01-05 Eastern Eye Care Vaught, James OD Gender: Male 11947 Grandhaven Drive, Unit M Provider ID: TPVVAUG08-01 Bergelt Optometric LLC Murrells Inlet, SC 29576 Gender: Male 545 Garden City Connector (843) 299-2485 Vaught Eye Associates Pa Murrells Inlet, SC 29576 Fax: (843) 299-2486 1406 Main Street (843) 651-4676 Mon - Thu 8:30 to 5:00 Conway, SC 29526 Fax: (843) 432-3189 Fri 8:30 to 12:00 (843) 488-2020 Tue, Thu 9:00 to 5:00 PCMH: No Fax: (843) 488-9659 Sat 9:00 to 1:00 Mon - Fri 7:00 to 7:00 PCMH: No Turbeville, Lisa OD Sat 8:00 to 12:00 Provider ID: TPVTURB01-02 PCMH: No Poston, Jerd OD Gender: Female Provider ID: TPVPOST02-02 Coastal Vision Center Inc Vaught, James Dylan OD Gender: Male 1651 Glenns Bay Road Provider ID: TPVVAUG09-01 Coastal Vision Center Inc Surfside Beach, SC 29575 Gender: Male 1651 Glenns Bay Road (843) 650-2400 Vaught Eye Associates Pa Surfside Beach, SC 29575 Fax: (843) 650-2525 1406 Main Street (843) 650-2400 Mon - Fri 8:00 to 5:30 Conway, SC 29526 Fax: (843) 650-2525 PCMH: No (843) 488-2020 Mon - Fri 8:00 to 5:30 Fax: (843) 488-9659 PCMH: No Mon, Thu 7:00 to 8:00 Tue - Wed, Fri 7:00 to 6:00 Sat 8:00 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 107 38642781

Specialty Physicians Horry Optometry - cont. Wise, Garett OD Boullion, Christopher DO Provider ID: TPVWISE11-01 Provider ID: 875509 Vaught, Heather OD Gender: Male Gender: Male Provider ID: TPVVAUG17-01 Vaught Eye Associates Pa Grand Strand Specialty Associates Gender: Female 1406 Main Street 8170 Rourk St Vaught Eye Associates Pa Conway, SC 29526 Myrtle Beach, SC 29572-4127 1406 Main Street (843) 488-2020 (843) 449-2336 Conway, SC 29526 Fax: (843) 488-9659 Fax: (843) 692-2174 (843) 488-0141 Mon - Fri 7:00 to 7:00 Grand Strand Regional Medical Fax: (843) 488-9659 Sat 8:00 to 12:00 Center Mon - Fri 7:00 to 7:00 PCMH: No Mon - Thu 8:00 to 5:00 Sat 8:00 to 12:00 Fri 8:00 to 3:00 PCMH: No Zeplin, Vincent OD PCMH: No Provider ID: TPVZEPL01-18 Weiner, Edward OD Gender: Male Boullion, Christopher DO Provider ID: TPVWEIN28-01 Greenwood Family Eyecare Inc Provider ID: 875509 Gender: Male 10820 Kings Road Gender: Male Vaught Eye Associates Pa Myrtle Beach, SC 29572 Grand Strand Surgical Associates 1406 Main Street (843) 449-4626 849 82nd Pkwy Conway, SC 29526 Fax: (843) 692-0409 Myrtle Beach, SC 29572-4614 (843) 488-2020 Mon - Fri 9:00 to 7:00 (843) 497-6348 Fax: (843) 488-9659 Sat 9:00 to 6:00 Fax: (843) 497-0625 Mon - Fri 7:00 to 7:00 PCMH: No Grand Strand Regional Medical Sat 8:00 to 12:00 Center PCMH: No Orthopaedic Surgery Mon - Thu 8:00 to 5:00 Fri 8:00 to 3:00 Williams, Ryan OD Andersen, Jason MD PCMH: No Provider ID: TPVWILL53-01 Provider ID: 2367541 Gender: Male Gender: Male Cook, Todd MD Socastee Eye Clinic Cmc Orthopaedics Provider ID: 1163725 4885 Socastee Boulevard 6010 Highway 707, Ste 200 Gender: Male Myrtle Beach, SC 29588 Myrtle Beach, SC 29588-7321 Carolina Orthopaedic Specialists (843) 293-8101 (843) 347-8041 5046 Highway 17 Byp S, Ste 202 Fax: (843) 293-8102 Fax: (843) 347-8042 Myrtle Beach, SC 29588 Mon - Fri 8:30 to 5:30 Mon - Fri 8:00 to 5:00 (843) 294-1941 PCMH: No PCMH: No Fax: (843) 294-1945 Mon - Thu 8:00 to 5:00 Wise, Garett OD Beck, David MD Fri 8:00 to 3:00 Provider ID: 936969 Provider ID: 2367482 PCMH: No Gender: Male Gender: Male Vaught Eye Associates Cmc Orthopaedics Cook, Todd MD 1406 Main St 6010 Highway 707, Ste 200 Provider ID: 1163725 Conway, SC 29526-3567 Myrtle Beach, SC 29588-7321 Gender: Male (843) 488-2020 (843) 347-8041 185 Fresh Dr, Ste B Fax: (843) 488-9659 Fax: (843) 347-8042 Myrtle Beach, SC 29579-4436 Mon - Fri 8:00 to 6:00 Mon - Fri 8:00 to 5:00 (843) 294-1941 Sat 8:00 to 12:00 PCMH: No Fax: (843) 294-1945 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 108 38642781

Specialty Physicians Horry Orthopaedic Surgery - cont. Ellison, Thomas MD Lewis, Jesse MD Provider ID: 1177537 Provider ID: 1523810 Cook, Todd MD Gender: Male Gender: Male Provider ID: 1163725 Georgetown Physician Associates Ll Georgetown Physician Associates Ll Gender: Male 4040 Highway 17, Ste 101 4040 Highway 17, Unit 101 Carolina Orthopaedic Specialists Murrells Inlet, SC 29576 Murrells Inlet, SC 29576-5098 3545 Highway 17, Ste 200 (843) 652-8160 (843) 652-8160 Murrells Inlet, SC 29576 Fax: (843) 652-8161 Fax: (843) 520-8365 (843) 294-1941 Mon - Fri 8:00 to 4:30 Mon - Fri 8:00 to 4:30 Fax: (843) 294-1945 PCMH: No PCMH: No Mon - Thu 8:00 to 5:00 Fri 8:00 to 3:00 PCMH: No Ellison, Thomas MD Lukowski, Peter MD Provider ID: 775772 Provider ID: 1032984 Gender: Male Gender: Male Didelot, William MD Waccamaw Orthopaedics LLC Mcleod Orthopaedics Seacoast Provider ID: 2378311 4040 Highway 17, Ste 101 3980 Highway 9 E, Ste 200 Gender: Male Murrells Inlet, SC 29576 Little River, SC 29566-8164 Tidelands Health Orthopaedics (843) 652-8160 (843) 390-0100 220 Crow Lane Fax: (843) 652-8161 Fax: (843) 390-0038 Myrtle Beach, SC 29577 Mon - Fri 9:00 to 5:00 Mcleod Loris Seacoast Ho (843) 848-5200 PCMH: No Mon - Fri 8:00 to 5:00 Fax: (843) 848-5205 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Greer, William MD Provider ID: 1186612 Lukowski, David MD Gender: Male Provider ID: 776517 Duncan V, Scott MD Georgetown Physician Associates Ll Gender: Male Provider ID: 1472090 4040 Highway 17, Suite 101 Mcleod Orthopaedic Associates Gender: Male Murrells Inlet, SC 29576 3980 Highway 9 E, Ste 200 Grand Strand Gme Program - (843) 652-8160 Little River, SC 29566-8164 Surgery Fax: (843) 652-8161 (843) 390-0100 8170 Rourk St, Ste 150 Mon - Fri 8:00 to 4:30 Fax: (843) 390-0038 Myrtle Beach, SC 29572-4127 PCMH: No Mon - Fri 9:00 to 5:00 (843) 848-1440 PCMH: No Fax: (843) 839-1654 Mon - Thu 8:00 to 5:00 Heimberger, Eric MD Fri 8:00 to 4:00 Provider ID: 964165 Mikol, Edward MD PCMH: No Gender: Male Provider ID: 769887 Mcleod Orthopaedics Seacoast Gender: Male 3980 Highway 9 E, Ste 200 Carolina Orthopedic Specialists LLC Duncan V, Scott MD Little River, SC 29566-8164 3515 Caduceus Dr, Ste B Provider ID: 1472090 (843) 390-0100 Myrtle Beach, SC 29588 Gender: Male Fax: (843) 390-0038 (843) 294-1941 Grand Strand Gme Program - Mcleod Loris Seacoast Ho Fax: (843) 294-1945 Surgery Mon - Fri 8:00 to 5:00 Mon, Wed 8:00 to 5:00 849 82nd Pkwy PCMH: No Tue, Thu 9:00 to 5:00 Myrtle Beach, SC 29572 Fri 8:00 to 12:00 (843) 497-6348 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 109 38642781

Specialty Physicians Horry Orthopaedic Surgery - cont. Taylor, Ross MD Pain Management Provider ID: 1655085 Putman, Stephen MD Gender: Male Tonkin, David MD Provider ID: 1174496 Mcleod Orthopaedics Seacoast Provider ID: 1462902 Gender: Male 3980 Highway 9 E, Ste 200 Gender: Male Carolina Orthopaedic Specialists Little River, SC 29566-8164 Elite Pain Management LLC 3545 Highway 17, Ste 200 (843) 390-0100 4237 River Hill Dr, Ste 170 Murrells Inlet, SC 29578 Fax: (843) 390-0038 Little River, SC 29566 (843) 294-1941 Mon - Thu 8:00 to 5:00 (843) 273-0376 Fax: (843) 294-1945 Fri 8:00 to 1:00 Fax: (843) 273-4515 Mon - Thu 8:00 to 5:00 PCMH: No Mon - Fri 8:00 to 5:00 Fri 8:00 to 3:00 PCMH: No PCMH: No Walsh, Christopher MD Provider ID: 1501428 Tonkin, David MD Putman, Stephen MD Gender: Male Provider ID: 1462902 Provider ID: 1174496 Mcleod Orthopaedics Seacoast Gender: Male Gender: Male 3980 Highway 9 E, Ste 200 Elite Pain Management LLC Carolina Orthopaedic Specialists Little River, SC 29566-8164 8212 Devon Ct 5046 Highway 17 Byp S, Ste 202 (843) 390-0100 Myrtle Beach, SC 29572-4178 Myrtle Beach, SC 29588 Fax: (843) 390-0038 (843) 273-0376 (843) 294-1941 Mon - Fri 8:00 to 5:00 Fax: (843) 273-4516 Fax: (843) 294-1945 PCMH: No Mon - Fri 8:30 to 5:00 Mon 8:00 to 12:00 PCMH: No Tue, Thu 8:00 to 5:00 PCMH: No Whiteside, William MD Provider ID: 1420278 Pediatric Surgery Gender: Male Morgan, Ross MD Putman, Jesse DO Georgetown Physician Associates Ll Provider ID: 2323121 Provider ID: 1856193 4040 Highway 17, Unit 101 Gender: Male Gender: Male Murrells Inlet, SC 29576-5098 Grand Strand Orthopedic Care Grand Strand Surgical Specialists (843) 652-8160 849 82nd Pkwy 920 Doug White Dr, Ste 120 Fax: (843) 652-8161 Myrtle Beach, SC 29572-4180 Myrtle Beach, SC 29572-4614 Mon - Fri 8:00 to 4:30 (407) 540-1000 (843) 848-1440 PCMH: No Fax: (843) 839-1654 Fax: (407) 540-1011 Mon - Fri 8:00 to 5:00 Mon - Thu 8:00 to 5:00 PCMH: No Young, Richard MD Fri 8:00 to 4:00 Provider ID: 774595 PCMH: No Gender: Male Single, Daniel MD Senside Orthopaedic Clinic Pediatrics Provider ID: 1186606 2021 N Myrtle PT Blvd, Ste 104 Gender: Male North Myrtle Beach, SC 29582 Bitar, Anas MD Georgetown Physician Associates Ll (843) 663-2663 Provider ID: 2224334 4040 Highway 17, Suite 101 Fax: (910) 575-9103 Gender: Male Murrells Inlet, SC 29576 Mon - Fri 8:00 to 5:00 Grand Strand Surgical Specialists (843) 652-8160 PCMH: No 920 Doug White Dr, Ste 150 Fax: (843) 652-8161 Myrtle Beach, SC 29572-4181 Mon - Fri 8:30 to 5:00 (843) 497-6348 PCMH: No Fax: (843) 497-6351 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 110 38642781

Specialty Physicians Horry Pediatrics - cont. Muresan, Horatiu MD Myers, William MD Provider ID: 1563989 Provider ID: 1427340 Hall, Megan DO Gender: Male Gender: Male Provider ID: 2177117 Grand Strand Surgical Specialists Myers Podiatry Clinic Gender: Female 8170 Rourk St, Ste 150 124 Porfessional Park Dr Cmc Pediatrics Towne Center Myrtle Beach, SC 29572-4127 Conway, SC 29526 5010 Carolina Forest Blvd (843) 848-1440 (843) 347-3334 Myrtle Beach, SC 29579-3579 Fax: (843) 839-1654 Fax: (843) 347-1393 (843) 236-2700 Mon - Thu 8:00 to 5:00 Mon, Wed, Fri 9:00 to 5:00 Fax: (843) 236-2726 Fri 8:00 to 4:00 Tue, Thu 8:30 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Sat - Sun 8:00 to 11:30 PCMH: No Muresan, Horatiu MD Myers, William MD Provider ID: 1563989 Provider ID: 1427340 Wakefield, Hannah MD Gender: Male Gender: Male Provider ID: 2352706 Grand Strand Surgical Specialists Myers Podiatry Clinic Gender: Female 849 82nd Pkwy 912 Inlet Square Dr Health Care Partners Of South Myrtle Beach, SC 29572-4614 Murrells Inlet, SC 29576 Carol (843) 497-6348 (843) 347-3334 1608 Main St Fax: (843) 497-6351 Fax: (843) 431-2786 Conway, SC 29526-3572 Mon - Thu 8:00 to 5:00 Mon, Wed, Fri 9:00 to 5:00 (843) 488-6030 Fri 8:00 to 4:00 Tue, Thu 8:30 to 5:00 Fax: (877) 322-0181 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 Sat 8:00 to 12:00 PCMH: No White, Steven MD Psychiatry Provider ID: 769848 Gender: Male Canaan, Yusef MD Physical Medicine & Rehabilitation Carolina Coastal Plastic And Recon Provider ID: 2376384 1275 21st Ave N, Building 1 Gender: Male Maybin, Ashley MD Grand Strand Behavioral Health Provider ID: 2367715 Myrtle Beach, SC 29577 (843) 448-9977 5050 Highway 17 Byp S Gender: Female Myrtle Beach, SC 29588-4500 Cmc Orthopaedics Fax: (843) 626-7755 Languages: French (843) 839-6090 8004 Myrtle Trace Dr, Ste 200 Fax: (843) 497-8305 Conway, SC 29526-8945 Mon - Thu 8:00 to 5:00 Fri - Sat 8:00 to 12:00 Mon - Fri 8:00 to 5:00 (843) 347-8041 PCMH: No Fax: (843) 347-8042 PCMH: No Mon - Thu 8:00 to 5:00 Fri 8:00 to 12:00 Podiatry Carrera-Alvarez, Amanda MD PCMH: No Provider ID: 1795343 Garland, Frederick DPM Gender: Female Provider ID: 2348491 Coastal Carolina Primary Care LLC Plastic & Reconstructive Surgery Gender: Male 809 82nd Pkwy Muresan, Horatiu MD Beachside Podiatry Myrtle Beach, SC 29572-4607 Provider ID: 1563989 767 Wintercreeper Dr (843) 291-7181 Gender: Male Longs, SC 29568-9229 Mon - Fri 8:00 to 5:00 Grand Strand Surgical Specialists (843) 653-0768 PCMH: No 199 Village Center Blvd, Ste 100 Mon - Fri 9:00 to 5:00 Myrtle Beach, SC 29579-3589 PCMH: No (843) 903-6459 Mon - Thu 8:00 to 5:00 Fri 8:00 to 4:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 111 38642781

Specialty Physicians Horry Psychiatry - cont. Moore, Barry MD Shissias, Charles MD Provider ID: 2264536 Provider ID: 2287554 Cluver, Jeffrey MD Gender: Male Gender: Male Provider ID: 2232286 Sandhills Integrated Care Grand Strand Behavioral Health Gender: Male 3993 Meeting St 5050 Highway 17 Byp S Grand Strand Behavioral Health Loris, SC 29569-3053 Myrtle Beach, SC 29588-4500 809 82nd Pkwy (909) 851-9120 (843) 839-6090 Myrtle Beach, SC 29572-4607 Fax: (919) 751-9170 Fax: (843) 497-8305 (843) 291-7182 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 291-7182 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Oduwole, Adedapo MD Psychology Provider ID: 908539 Czepowicz, Violetta MD Gender: Male Norton, Laura PHD Provider ID: 2022803 Mofdaps And Company Provider ID: 1139001 Gender: Female 1203 48th Ave N, Ste 202 Gender: Female Coastal Carolina Primary Care LLC Myrtle Beach, SC 29577-5425 Little River Medical Center Inc 809 82nd Parkway (843) 449-2576 4303 Live Oak Dr Myrtle Beach, SC 29572 Fax: (843) 449-6851 Little River, SC 29566-9138 (843) 291-7182 Languages: Yoruba (843) 663-8000 Fax: (843) 291-7182 Mon - Fri 9:00 to 6:00 Fax: (843) 663-8123 Mon - Fri 8:00 to 5:00 PCMH: No Mon - Fri 8:30 to 4:30 PCMH: No PCMH: No Praylow, Tiona MD Lilly, Brandon MD Provider ID: 2400620 Pulmonary Disease Provider ID: 2129459 Gender: Female Ali, Hamed MD Gender: Male Grand Strand Behavioral Health Coastal Carolina Primary Care LLC Provider ID: 771818 5050 Highway 17 Byp S Gender: Male 809 82nd Pkwy Myrtle Beach, SC 29588-4500 Myrtle Beach, SC 29572-4607 Carolina Health Specialists (843) 839-6090 809 82nd Pkwy (843) 291-7182 Fax: (843) 497-8305 Fax: (843) 291-7182 Myrtle Beach, SC 29572 Mon - Fri 8:00 to 5:00 (843) 497-5929 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No Roberson, Caroljane MD Lynn, Christina MD Provider ID: 2321791 Provider ID: 2023390 Chandler, Thomas MD Gender: Female Provider ID: 774023 Gender: Female Grand Strand Behavioral Health Coastal Carolina Primary Care LLC Gender: Male 809 82nd Pkwy Inlet Pulmonary Critical Care And S 809 82nd Parkway Myrtle Beach, SC 29572-4607 Myrtle Beach, SC 29572 4057 Highway 17 (843) 291-7182 Murrells Inlet, SC 29576 (843) 291-7182 Fax: (843) 291-7182 Fax: (843) 291-7182 (843) 235-3131 Mon - Fri 8:00 to 5:00 Fax: (843) 237-9797 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Mon, Wed, Fri 9:00 to 5:00 Tue, Thu 9:00 to 2:30 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 112 38642781

Specialty Physicians Horry Pulmonary Disease - cont. Miara, Melissa DO Andrews, Stephen DO Provider ID: 1923391 Provider ID: 774037 Dineen, Kevin MD Gender: Female Gender: Male Provider ID: 1330257 Mcleod Pulmonary & Critical Care Carolina Regional Cancer Center Gender: Male SE 8059 Myrtle Trace Dr Mcleod Pulmonary Critical Care SE 3617 Casey St, Ste C Conway, SC 29526-8946 107 Mcleod Health Blvd, Ste 207 Loris, SC 29569-2981 (843) 234-5505 Myrtle Beach, SC 29579-4477 (843) 716-7911 Fax: (843) 234-5507 (843) 390-8302 Fax: (843) 716-7918 Mon - Fri 8:00 to 5:00 Fax: (843) 390-8315 Mon - Fri 8:00 to 5:00 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Francke, Patrick MD Sharma, Snigdha MD Provider ID: 774386 Dineen, Kevin MD Provider ID: 2322052 Gender: Male Provider ID: 1330257 Gender: Female Carolina Regional Cancer Center Gender: Male Cmc Pulmonary And Sleep 4708 Oleander Dr Mcleod Pulmonary Critical Care Sea Medicine Myrtle Beach, SC 29577 3617 Casey St, Ste C 2376 Cypress Cir, Ste 100 (843) 449-9415 Loris, SC 29569-2981 Conway, SC 29526 Fax: (843) 449-2160 (843) 716-7911 (843) 234-6888 Mon - Fri 8:00 to 5:00 Fax: (843) 716-7918 Fax: (843) 234-6889 PCMH: No Mon - Fri 8:00 to 5:00 Mon - Thu 8:30 to 5:00 PCMH: No Fri 8:30 to 1:00 Francke, Patrick MD PCMH: No Provider ID: 774386 Hayek, Hafez MD Gender: Male Provider ID: 912628 Young, Desmond MD Carolina Regional Cancer Center Gender: Male Provider ID: 775622 8059 Myrtle Trace Dr 300 Singleton Ridge Rd Gender: Male Conway, SC 29526-8946 Conway, SC 29526-9142 Inlet Cardiopulmonary And Asso- (843) 234-5505 (843) 347-7111 ciate Fax: (843) 234-5507 Languages: Arabic, French 4057 Highway 17 Mon - Fri 8:00 to 5:00 PCMH: No Murrells Inlet, SC 29576 PCMH: No (843) 235-3131 Jona, Vinod MD Fax: (843) 237-9797 Thurman, Sarah MD Provider ID: 770927 Mon 11:00 to 2:30 Provider ID: 1587565 Gender: Male Tue, Thu 9:00 to 5:00 Gender: Female Pee Dee Cardiology Associates Wed 10:00 to 2:30 Musc Health Partners 3485 Mitchell St Fri 10:00 to 1:30 4033 Highway 17 Loris, SC 29569 PCMH: No Murrells Inlet, SC 29576 (843) 756-7029 (843) 545-5600 Fax: (843) 756-7033 Radiation Oncology Fax: (843) 545-5660 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No Andrews, Stephen DO PCMH: No Provider ID: 774037 Gender: Male Carolina Regional Cancer Center Zaenger, David MD 4708 Oleander Dr Provider ID: 1654694 Myrtle Beach, SC 29577 Gender: Male (843) 449-9415 Carolina Regional Cancer Center Ll Fax: (843) 449-2160 4708 Oleander Dr Mon - Fri 8:00 to 5:00 Myrtle Beach, SC 29577-5742 PCMH: No (843) 449-9415 Fax: (843) 449-2160 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 113 38642781

Specialty Physicians Horry Radiation Oncology - cont. Twining, Jon MD Gersch, Karen MD Provider ID: 774059 Provider ID: 1474021 Zaenger, David MD Gender: Male Gender: Female Provider ID: 1654694 Carolina Rheumatology And Neur- Grand Strand Surgical Specialists L Gender: Male ology 8210 Devon Ct Carolina Regional Cancer Center Ll 8220 Nigels Dr Myrtle Beach, SC 29572 8059 Myrtle Trace Dr Myrtle Beach, SC 29572 (843) 497-7772 Conway, SC 29526-8946 (843) 692-0968 Fax: (843) 848-7530 (834) 234-5505 Fax: (843) 692-2688 Mon - Fri 8:30 to 5:00 Fax: (843) 234-5507 Mon - Fri 8:00 to 5:00 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Gersch, Karen MD Thoracic & Cardiovascular Surgery Provider ID: 1474021 Rheumatology Gender: Female Appleby, Douglas MD Grand Strand Surgical Specialists L Lee, Wendy MD Provider ID: 2022620 Provider ID: 773518 933 Medical Cir Gender: Male Myrtle Beach, SC 29572 Gender: Female Grand Strand Surgical Specialists Carolina Rheumatology Neurology (843) 497-7772 933 Medical Circle Fax: (843) 497-7627 As Myrtle Beach, SC 29572-4116 8220 Nigels Dr Mon - Fri 9:00 to 5:00 (843) 497-7772 PCMH: No Myrtle Beach, SC 29572 Fax: (843) 497-7627 (843) 692-0968 Mon - Fri 9:00 to 5:00 Fax: (843) 692-2688 PCMH: No Johnson, Alan MD Languages: Mandarin Provider ID: 2023281 Mon 8:00 to 4:00 Gender: Male Tue, Fri 9:00 to 5:00 Cunningham, Christopher MD Grand Strand Surgical Specialists Wed - Thu 8:00 to 2:30 Provider ID: 773957 933 Medical Circle PCMH: No Gender: Male Myrtle Beach, SC 29572-4116 Mcleod Vascular Associates (843) 497-7772 Seacoast Fax: (843) 497-7627 Lee, Wendy MD 3980 Highway 9 E, Ste 240 Provider ID: 773518 Mon - Fri 9:00 to 5:00 Little River, SC 29566 PCMH: No Gender: Female (843) 366-9155 Carolina Rheumatology And Neur- Fax: (843) 366-3750 ology Mon - Fri 9:00 to 5:00 Mcintyre, Alex MD 4835 Hwy 17 Bypass South PCMH: No Provider ID: 1854093 Murrells Inlet, SC 29576 Gender: Male (843) 357-1021 Healogics Specialty Physicians Of S Fax: (843) 692-2688 Denlinger, Chadrick MD 300 Singleton Ridge Rd Languages: Mandarin Provider ID: 1266718 Conway, SC 29526-9142 Tue 9:00 to 4:00 Gender: Male (843) 347-8347 PCMH: No Musc Health Cardiopulmonary Fax: (904) 446-3032 4057 Highway 17 Mon - Fri 8:00 to 5:00 Murrells Inlet, SC 29576-5032 PCMH: No Twining, Jon MD (843) 876-4844 Provider ID: 774059 Mon - Fri 8:00 to 5:00 Gender: Male PCMH: No Mcintyre, Alex MD Carolina Rheumatology And Neur- Provider ID: 1854093 ology Gender: Male 4835 Hwy 17 Bypass South Healogics Specialty Physicians Of S Murrells Inlet, SC 29576 5050 Highway 17 Byp S (843) 357-1021 Myrtle Beach, SC 29588-4500 Fax: (843) 692-2688 (843) 692-4540 Mon - Tue, Thu 8:30 to 4:00 Fax: (843) 839-6006 Wed, Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 114 38642781

Specialty Physicians Horry Thoracic & Cardiovascular Surgery - Stahl, Russell MD Fogarty, James DO cont. Provider ID: 1258449 Provider ID: 775936 Gender: Male Gender: Male Perry, John MD Grand Strand Surgical Specialists Coastal Urology Center Provider ID: 2222425 933 Medical Cir 394 Singleton Ridge Rd Gender: Male Myrtle Beach, SC 29572 Conway, SC 29526-9153 Grand Strand Surgical Specialists (843) 497-7772 (843) 347-8765 920 Doug White Dr, Ste 510 Fax: (843) 497-6351 Fax: (843) 347-3499 Myrtle Beach, SC 29572-4183 Mon - Thu 9:00 to 5:00 Mon - Tue 1:00 to 5:00 (843) 497-7772 Fri 9:00 to 4:00 Wed 8:00 to 5:00 Fax: (843) 497-7627 PCMH: No Thu 8:00 to 12:00 Mon - Fri 8:00 to 5:00 Fri 8:00 to 4:00 PCMH: No Urology PCMH: No Takara, James MD Cerasaro, Thomas MD Fogarty, James DO Provider ID: 2391751 Provider ID: 771925 Provider ID: 775936 Gender: Male Gender: Male Gender: Male Grand Strand Heart Vascular Care Atlantic Urology Clinics 199 Vlg Ctr Blvd, Ste 100 920 Doug White Dr, Ste 510 4367 Riverwood Dr, Unit 100 Myrtle Beach, SC 29579-3589 Myrtle Beach, SC 29572-4183 Murrells Inlet, SC 29576-4381 (843) 347-2450 (843) 497-7772 (843) 652-4000 Fax: (843) 236-4746 Fax: (843) 848-7530 Fax: (843) 652-4004 PCMH: No Mon - Fri 8:00 to 5:00 Mon, Wed - Fri 8:30 to 5:00 PCMH: No Tue 9:00 to 5:00 PCMH: No Fogarty, James DO Provider ID: 775936 Thoracic Surgery Gender: Male Cerasaro, Thomas MD Atlantic Urology Clinics LLC Didolkar, Parijat MD Provider ID: 771925 3600 Sea Mountain Hwy, Ste B Provider ID: 2377441 Gender: Male Little River, SC 29566-8161 Gender: Male Atlantic Urology Clinics LLC (843) 399-9696 Grand Strand Heart Vascular Care 3600 Sea Mountain Hwy, Ste D Fax: (843) 399-8932 920 Doug White Dr, Ste 510 Little River, SC 29566-8161 Mon - Fri 9:00 to 5:00 Myrtle Beach, SC 29572-4183 (843) 399-8930 PCMH: No (843) 497-7772 Fax: (843) 399-8932 Fax: (843) 848-7530 Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No Fogarty, James DO PCMH: No Provider ID: 775936 Gender: Male Cerasaro, Thomas MD Atlantic Urology Clinics LLC Stahl, Russell MD Provider ID: 771925 402 Singleton Ridge Rd Provider ID: 1258449 Gender: Male Conway, SC 29526-9153 Gender: Male Atlantic Urology Clinics LLC (843) 347-0267 Grand Strand Surgical Specialists 101 Mcleod Health Blvd, Ste 202 Fax: (843) 347-0346 8210 Devon Ct Myrtle Beach, SC 29579-4477 Mon - Fri 8:00 to 5:00 Myrtle Beach, SC 29572 (843) 236-5004 PCMH: No (843) 497-7772 Fax: (843) 236-4746 Fax: (843) 848-7530 Mon - Fri 9:00 to 5:00 Mon - Thu 8:30 to 5:00 PCMH: No Fri 8:30 to 4:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 115 38642781

Specialty Physicians Horry Urology - cont. Gajewski, Timothy MD Gajewski, Timothy MD Provider ID: 2266763 Provider ID: 2266763 Fogarty, James DO Gender: Male Gender: Male Provider ID: 775936 Atlantic Urology Clinics LLC Atlantic Urology Clinics LLC Gender: Male 101 Mcleod Health Blvd, Ste 202 394 Singleton Ridge Rd Atlantic Urology Clinics LLC Myrtle Beach, SC 29579-4477 Conway, SC 29526-9150 101 Mcleod Health Blvd, Ste 202 (843) 236-4949 (843) 347-8765 Myrtle Beach, SC 29579-4477 Fax: (843) 236-4746 Fax: (843) 347-3499 (843) 347-2450 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 236-4746 PCMH: No PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No Gajewski, Timothy MD Gangi, Glenn MD Provider ID: 2266763 Provider ID: 776932 Frank, Walter MD Gender: Male Gender: Male Provider ID: 771580 Atlantic Urology Clinics LLC 1213 Elm St Gender: Male 1213 Elm St Aynor, SC 29511-3320 Atlantic Urology Clinics Aynor, SC 29511-3320 (843) 756-6319 4367 Riverwood Dr, Unit 100 (843) 756-6319 Fax: (843) 756-5205 Murrells Inlet, SC 29576-4381 Fax: (843) 756-5205 PCMH: No (843) 652-4000 Mon - Fri 8:00 to 5:00 Fax: (843) 652-4004 PCMH: No Mon, Wed - Fri 8:30 to 5:00 Gangi, Glenn MD Tue 9:00 to 5:00 Provider ID: 776932 PCMH: No Gajewski, Timothy MD Gender: Male Provider ID: 2266763 3617 Casey St, Ste B Gender: Male Loris, SC 29569-2981 Frank, Walter MD Atlantic Urology Clinics LLC (843) 756-5186 Provider ID: 771580 3600 Sea Mountain Hwy, Ste B Fax: (843) 756-5205 Gender: Male Little River, SC 29566-8161 PCMH: No Atlantic Urology Clinics LLC (843) 399-9696 3600 Sea Mountain Hwy, Ste D Fax: (843) 399-9596 Little River, SC 29566-8161 Gangi, Glenn MD Mon - Fri 8:00 to 5:00 Provider ID: 776932 (843) 399-8930 PCMH: No Fax: (843) 399-8932 Gender: Male Mon - Fri 9:00 to 5:00 Atlantic Urology Clinics PCMH: No Gajewski, Timothy MD 402 Singleton Ridge Rd, Ste B Provider ID: 2266763 Conway, SC 29526 Gender: Male (843) 347-8600 Frank, Walter MD Atlantic Urology Clinics LLC Fax: (843) 347-8702 Provider ID: 771580 3600 Sea Mountain Hwy, Ste D Mon - Fri 9:00 to 5:00 Gender: Male Little River, SC 29566-8161 PCMH: No Atlantic Urology Clinics LLC (843) 390-8521 3911 Highway 17 Fax: (843) 399-8932 Murrells Inlet, SC 29576-5014 Gangi, Glenn MD Mon - Fri 8:00 to 5:00 Provider ID: 776932 (843) 652-4000 PCMH: No Fax: (843) 652-4004 Gender: Male Mon - Fri 8:00 to 5:00 Atlantic Urology Clinics LLC PCMH: No Gajewski, Timothy MD 3600 Sea Mountain Hwy, Ste D Provider ID: 2266763 Little River, SC 29566-8161 Gender: Male (843) 399-8930 Atlantic Urology Clinics LLC Fax: (843) 399-8932 3617 Casey St, Ste B Mon - Fri 9:00 to 5:00 Loris, SC 29569-2981 PCMH: No (843) 756-6319 Fax: (843) 756-5205 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 116 38642781

Specialty Physicians Horry Urology - cont. Jansen, Robert MD Rich, David MD Provider ID: 1010218 Provider ID: 1648411 Gangi, Glenn MD Gender: Male Gender: Male Provider ID: 776932 Atlantic Urology Clinics LLC Atlantic Urology Clinics LLC Gender: Male 823 82nd Pkwy 101 Mcleod Health Blvd, Ste 202 Atlantic Urology Clinics LLC Myrtle Beach, SC 29572-4607 Myrtle Beach, SC 29579-4477 101 Mcleod Health Blvd, Ste 202 (843) 449-1010 (843) 236-4949 Myrtle Beach, SC 29579-4477 Fax: (843) 497-6171 Fax: (843) 236-4746 (843) 347-2450 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 236-4746 PCMH: No PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No Quillen, Timothy MD Rich, David MD Provider ID: 774449 Provider ID: 1648411 Jansen, Robert MD Gender: Male Gender: Male Provider ID: 1010218 Atlantic Urology Clinics Atlantic Urology Clinics LLC Gender: Male 394 Singleton Ridge Rd 5046 Highway 17 Byp S, Ste 200 Atlantic Urology Clinics LLC Conway, SC 29526-9153 Myrtle Beach, SC 29588-4503 101 Mcleod Health Blvd, Ste 202 (843) 347-8765 (843) 347-2450 Myrtle Beach, SC 29579-4477 Fax: (843) 347-3499 Fax: (843) 293-0448 (843) 347-2450 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 236-4746 PCMH: No PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No Quillen, Timothy MD Roberts, Brian MD Provider ID: 774449 Provider ID: 775189 Jansen, Robert MD Gender: Male Gender: Male Provider ID: 1010218 Atlantic Urology Clinics LLC 199 Vlg Ctr Blvd, Ste 100 Gender: Male 3600 Sea Mountain Hwy, Ste D Myrtle Beach, SC 29579-3589 Atlantic Urology Clinics LLC Little River, SC 29566-8161 (843) 347-2450 5046 Highway 17 Byp S, Ste 200 (843) 399-8930 Fax: (843) 236-4746 Myrtle Beach, SC 29588-4503 Fax: (843) 399-8932 PCMH: No (843) 347-2450 Mon - Fri 9:00 to 5:00 Fax: (843) 293-0448 PCMH: No Mon - Fri 8:00 to 5:00 Roberts, Brian MD PCMH: No Provider ID: 775189 Quillen, Timothy MD Gender: Male Provider ID: 774449 Atlantic Urology Clinics Jansen, Robert MD Gender: Male 823 82nd Pkwy Provider ID: 1010218 Atlantic Urology Clinics LLC Myrtle Beach, SC 29572-4607 Gender: Male 402 Singleton Ridge Rd (843) 449-1010 Atlantic Urology Clinics LLC Conway, SC 29526-9153 Fax: (843) 497-6171 3600 Sea Mountain Hwy, Ste B (843) 347-0267 Mon - Fri 8:30 to 4:30 Little River, SC 29566-8161 Fax: (843) 347-0346 PCMH: No (843) 280-5151 Mon - Fri 8:00 to 5:00 Fax: (843) 399-9596 PCMH: No Mon - Fri 8:00 to 5:00 Roberts, Brian MD PCMH: No Provider ID: 775189 Quillen, Timothy MD Gender: Male Provider ID: 774449 Atlantic Urology Clinics LLC Gender: Male 3600 Sea Mountain Hwy, Ste D Atlantic Urology Clinics LLC Little River, SC 29566-8161 101 Mcleod Health Blvd, Ste 202 (843) 399-8930 Myrtle Beach, SC 29579-4477 Fax: (843) 399-8932 (843) 347-2450 Mon - Fri 9:00 to 5:00 Fax: (843) 236-4746 PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 117 38642781

Specialty Physicians Horry Urology - cont. Shore, Neal MD Srivastava, Abhishek MD Provider ID: 771700 Provider ID: 2294960 Roberts, Brian MD Gender: Male Gender: Male Provider ID: 775189 Atlantic Urology Clinics LLC Atlantic Urology Clinics LLC Gender: Male 3600 Sea Mountain Hwy, Ste D 101 Mcleod Health Blvd, Ste 202 Atlantic Urology Clinics LLC Little River, SC 29566-8161 Myrtle Beach, SC 29579-4477 101 Mcleod Health Blvd, Ste 202 (843) 399-8930 (843) 236-4949 Myrtle Beach, SC 29579-4477 Fax: (843) 399-8932 Fax: (843) 236-4746 (843) 347-2450 Grand Strand Regional Medical Mon - Fri 8:00 to 5:00 Fax: (843) 236-4746 Center PCMH: No Mon - Fri 9:00 to 5:00 Mon - Fri 9:00 to 5:00 PCMH: No PCMH: No Srivastava, Abhishek MD Provider ID: 2294960 Roberts, Brian MD Shore, Neal MD Gender: Male Provider ID: 775189 Provider ID: 771700 Atlantic Urology Clinics LLC Gender: Male Gender: Male 3600 Sea Mountain Hwy, Ste B Atlantic Urology Clinics LLC Atlantic Urology Clinics LLC Little River, SC 29566-8161 5046 Highway 17 Byp S, Ste 200 101 Mcleod Health Blvd, Ste 202 (843) 280-5151 Myrtle Beach, SC 29588-4503 Myrtle Beach, SC 29579-4477 Fax: (843) 399-9596 (843) 347-2450 (843) 347-2450 Mon - Fri 8:00 to 5:00 Fax: (843) 293-0448 Fax: (843) 236-4746 PCMH: No Mon - Fri 8:00 to 5:00 Grand Strand Regional Medical PCMH: No Center Srivastava, Abhishek MD Mon - Fri 9:00 to 5:00 Provider ID: 2294960 Roberts, Brian MD PCMH: No Gender: Male Provider ID: 775189 Atlantic Urology Clinics LLC Gender: Male Shore, Neal MD 3600 Sea Mountain Hwy, Ste D Mi Grand Strand Urology Provider ID: 771700 Little River, SC 29566-8161 4367 Riverwood Dr, Unit 110 Gender: Male (843) 390-8521 Murrells Inlet, SC 29576-4381 Atlantic Urology Clinics LLC Fax: (843) 399-8932 (843) 357-1066 5046 Highway 17 Byp S, Ste 200 Mon - Fri 8:00 to 5:00 Fax: (843) 357-1119 Myrtle Beach, SC 29588-4503 PCMH: No Mon - Fri 8:00 to 4:30 (843) 347-2450 PCMH: No Fax: (843) 293-0448 Srivastava, Abhishek MD Grand Strand Regional Medical Provider ID: 2294960 Shore, Neal MD Center Gender: Male Provider ID: 771700 Mon - Fri 8:00 to 5:00 Atlantic Urology Clinics LLC Gender: Male PCMH: No 5046 Highway 17 Byp S, Ste 200 Atlantic Urology Clinics Myrtle Beach, SC 29588-4503 823 82nd Pkwy, Mb Grand Strand Shore, Neal MD (843) 347-2450 Urology Provider ID: 771700 Fax: (843) 293-0448 Myrtle Beach, SC 29572-4607 Gender: Male Mon - Fri 8:00 to 5:00 (843) 449-1010 827 82nd Pkwy PCMH: No Fax: (843) 497-6171 Myrtle Beach, SC 29572-4607 Grand Strand Regional Medical (843) 286-2020 Center Srivastava, Abhishek MD Fax: (843) 286-2030 Provider ID: 2294960 Mon - Fri 8:00 to 4:30 Grand Strand Regional Medical PCMH: No Gender: Male Center Atlantic Urology Clinics LLC PCMH: No 823 82nd Pkwy Myrtle Beach, SC 29572-4607 (843) 449-1010 Fax: (843) 497-6171 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 118 38642781

Specialty Physicians Horry Urology - cont. Young, Matthew MD Young, Richard MD Provider ID: 1964157 Provider ID: 773672 Wood, Joseph MD Gender: Male Gender: Male Provider ID: 776536 Atlantic Urology Clinics LLC Atlantic Urology Clinics LLC Gender: Male 101 Mcleod Health Blvd, Ste 202 3600 Sea Mountain Hwy, Ste D Atlantic Urology Clinics Myrtle Beach, SC 29579 Little River, SC 29566-8161 394 Singleton Ridge Rd (843) 236-4949 (843) 399-8930 Conway, SC 29526-9153 Fax: (843) 236-4746 Fax: (843) 399-8932 (843) 347-8765 Mon - Fri 8:00 to 5:00 Mon - Fri 9:00 to 5:00 Fax: (843) 347-3499 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Young, Matthew MD Young, Richard MD Provider ID: 1964157 Provider ID: 773672 Wood, Joseph MD Gender: Male Gender: Male Provider ID: 776536 Atlantic Urology Clinics LLC Atlantic Urology Clinics LLC Gender: Male 3600 Sea Mountain Hwy, Ste D 101 Mcleod Health Blvd, Ste 202 Atlantic Urology Clinics LLC Little River, SC 29566 Myrtle Beach, SC 29579-4477 3600 Sea Mountain Hwy, Ste D (843) 390-8521 (843) 347-2450 Little River, SC 29566-8161 Fax: (843) 399-8932 Fax: (843) 236-4746 (843) 399-8930 Mon - Fri 8:00 to 5:00 Mon - Fri 9:00 to 5:00 Fax: (843) 399-8932 PCMH: No PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No Young, Matthew MD Young, Richard MD Provider ID: 1964157 Provider ID: 773672 Wood, Joseph MD Gender: Male Gender: Male Provider ID: 776536 Atlantic Urology Clinics LLC Atlantic Urology Clinics LLC Gender: Male 394 Singleton Ridge Rd 5046 Highway 17 Byp S, Ste 200 Atlantic Urology Clinics LLC Conway, SC 29526-9150 Myrtle Beach, SC 29588-4503 402 Singleton Ridge Rd (843) 347-8765 (843) 347-2450 Conway, SC 29526-9153 Fax: (843) 347-3499 Fax: (843) 293-0448 (843) 347-0267 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 347-0346 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Young, Matthew MD Young, Richard MD Provider ID: 1964157 Provider ID: 773672 Wood, Joseph MD Gender: Male Gender: Male Provider ID: 776536 Atlantic Urology Clinics LLC 809 82nd Pkwy Gender: Male 402 Singleton Ridge Rd Myrtle Beach, SC 29572-4607 Atlantic Urology Clinics LLC Conway, SC 29526 (843) 692-1000 101 Mcleod Health Blvd, Ste 202 (843) 347-0267 PCMH: No Myrtle Beach, SC 29579-4477 Fax: (843) 347-0346 (843) 236-5004 Mon - Fri 8:00 to 5:00 Vascular Surgery Fax: (843) 236-4746 PCMH: No Mon - Fri 9:00 to 5:00 Keefer, Adam MD PCMH: No Young, Richard MD Provider ID: 1237473 Provider ID: 773672 Gender: Male Wood, Joseph MD Gender: Male Coastal Vascular And Vein Center Provider ID: 776536 Atlantic Urology Clinics Pa Gender: Male 823 82nd Pkwy 4835 Highway 17 822 Farrar Dr Myrtle Beach, SC 29572-4607 Murrells Inlet, SC 29576 Conway, SC 29526-8747 (843) 449-1010 (843) 577-4551 (843) 347-9587 Fax: (843) 497-6171 Fax: (843) 577-8868 Fax: (843) 347-9633 Mon - Fri 8:00 to 4:30 Tue - Wed 9:00 to 2:00 PCMH: No PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 119 38642781

Specialty Physicians Horry Vascular Surgery - cont. Piccolo, Carmen DO Provider ID: 1148987 Gender: Male Mcleod Vascular Associates Seacoast 3980 Highway 9 E, Ste 240 Little River, SC 29566 (843) 366-9155 Fax: (843) 366-3750 Mon - Fri 9:00 to 5:00 PCMH: No

Rzucidlo, Eva MD Provider ID: 1164665 Gender: Female Mcleod Vascular Associates Seacoast 3980 Highway 9 E, Ste 240 Little River, SC 29566-8164 (843) 366-9155 Fax: (843) 366-3750 Mon - Fri 8:00 to 5:00 PCMH: No

Winkler, Gabor MD Provider ID: 945371 Gender: Male Mcleod Vascular Associates Seacoast 3980 Highway 9 E, Ste 240 Little River, SC 29566-8164 (843) 366-9155 Fax: (843) 366-3750 Languages: German, Hungarian, Russian Mon - Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 120 38642781

Specialty Physicians Marion Cardiology Floyd Norris, Iris MD Thomas, Chadwick MD Provider ID: 766894 Provider ID: 1278944 Ng, Daniel MD Gender: Female Gender: Male Provider ID: 1840852 Musc Physicians Primary Care Musc Physicians General Surgery Gender: Male Marion Mul Musc Physicians Cardiology Marion 2835 E Highway 76, Ste 7 119 W Lowman St M Mullins, SC 29574-6038 Mullins, SC 29574 2835 E Highway 76, Ste 5 (843) 431-2710 (843) 464-4000 Mullins, SC 29574-6038 Fax: (843) 431-2716 Fax: (843) 464-4017 (843) 431-2171 Musc Health Marion Medical Musc Health Marion Medical Fax: (843) 423-3739 Center Center Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No

Chiropractic General Surgery Internal Medicine Falk, Mitchell DC Degrood, Robert MD Abinsay, Alvin MD Provider ID: 777281 Provider ID: 936089 Provider ID: 774962 Gender: Male Gender: Male Gender: Male Spinal Care Center Of Mullins Musc Physicians General Surgery Comprehensive Hospitalist Services 270 S Main St Mul 2829 E Highway 76 Mullins, SC 29574 119 W Lowman St Mullins, SC 29574 (843) 464-8700 Mullins, SC 29574 (877) 693-5700 Fax: (843) 464-1670 (843) 464-4000 Mon - Fri 9:00 to 5:00 Mon - Wed, Fri 8:00 to 6:00 Fax: (843) 464-4017 PCMH: No Thu, Sat 8:00 to 12:30 Musc Health Marion Medical PCMH: No Center Bullard, Robert MD Mon - Fri 8:00 to 5:00 Provider ID: 770232 Sealey, Darren DC PCMH: No Gender: Male Provider ID: 1522530 Comprehensive Hospitalist Services Gender: Male Gopalakrishnan, Parakkat MD 2829 E Highway 76 Palmetto Wellness And Injury Mullins, SC 29574 Center Provider ID: 1849544 (877) 693-5700 2516 E Hwy 76 Gender: Female Mon - Fri 9:00 to 5:00 Marion, SC 29571 Musc Physicians General Surgery PCMH: No (843) 423-7363 Mul Fax: (843) 423-7364 119 W Lowman St Mon - Thu 8:30 to 5:30 Mullins, SC 29574 Demarco, Paul MD Fri 8:30 to 1:00 (843) 464-4000 Provider ID: 774056 PCMH: No Fax: (843) 464-4017 Gender: Male Musc Health Marion Medical Comprehensive Hospitalist Services 2829 E Highway 76 Family Practice Center Mon - Fri 8:00 to 5:00 Mullins, SC 29574 Bethea, Lesa MD PCMH: No (877) 693-5700 Provider ID: 775574 Mon - Fri 9:00 to 5:00 Gender: Female PCMH: No Comprehensive Hospitalist Services 2829 E Highway 76 Mullins, SC 29574 (877) 693-5700 Mon - Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 121 38642781

Specialty Physicians Marion Internal Medicine - cont. Woodberry, William MD Urology Provider ID: 776300 Hazelwood, William MD Gender: Male Gajewski, Timothy MD Provider ID: 770454 Comprehensive Hospitalist Services Provider ID: 2266763 Gender: Male 2829 E Highway 76 Gender: Male Comprehensive Hospitalists Servs Mullins, SC 29574 Atlantic Urology Clinics LLC Of (877) 693-5700 2835 E Highway 76, Ste 3 2829 E Highway 76 Mon - Fri 9:00 to 5:00 Mullins, SC 29574-6038 Mullins, SC 29574 PCMH: No (843) 423-0230 (877) 693-5700 Fax: (843) 423-0802 Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No Obstetrics/Gynecology PCMH: No Burke, Valerie MD Mathisuthan, Gangatharan MD Provider ID: 776707 O'kelly, James MD Gender: Female Provider ID: 2354537 Provider ID: 777304 Health Care Partners Of Sc Gender: Male Gender: Male 145 Palmetto Pointe Rd Musc Physicians Marion Urology Comprehensive Hospitalist Services Marion, SC 29571 2835 E Highway 76, Ste 2 2829 E Highway 76 (843) 248-4700 Mullins, SC 29574 Mullins, SC 29574 Mon - Fri 9:00 to 5:00 (843) 431-2140 (877) 693-5700 PCMH: No Fax: (843) 431-2146 Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No Optometry PCMH: No Offiong, Dominic MD Vinson, Mark OD Provider ID: 773502 Provider ID: TPVVINS01-02 Gender: Male Gender: Male Comprehensive Hospitalist Services Vision Care Pa 2829 E Highway 76 2614 East Highway 76 Mullins, SC 29574 Marion, SC 29571 (877) 693-5700 (843) 423-7229 Mon - Fri 9:00 to 5:00 Fax: (843) 423-1971 PCMH: No Mon - Thu 10:00 to 4:00 Fri 10:00 to 2:00 PCMH: No Ortiz, Veronica MD Provider ID: 775975 Gender: Female Orthopaedic Surgery Comprehensive Hospitalist Services Hamilton, Frederick DO 2829 E Highway 76 Provider ID: 1419770 Mullins, SC 29574 Gender: Male (877) 693-5700 Musc Physicians Orthopaedics Mon - Fri 9:00 to 5:00 Marion PCMH: No 2835 E Highway 76, Ste 5 Mullins, SC 29574-6038 Shakeel, Muhammad MD (843) 431-2280 Provider ID: 773348 Fax: (843) 431-2297 Gender: Male Musc Health Marion Medical Comprehensive Hospitalist Services Center 2829 E Highway 76 Mon - Fri 8:00 to 5:00 Mullins, SC 29574 PCMH: No (877) 693-5700 Mon - Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 122 38642781

Specialty Physicians Marlboro General Surgery Kolb, Cynthia MD Provider ID: 774288 Jordan, Henry MD Gender: Female Provider ID: 1227095 Mcleod Ob/Gyn Bennettsville Gender: Male 1040 Marlboro Way, Ste 7 Mcleod Surgery Cheraw Bennettsville, SC 29512-2494 1076 Marlboro Way, Ste 6 (843) 777-9140 Bennettsville, SC 29512-2495 Fax: (843) 777-7914 (843) 545-7677 Mon - Fri 9:00 to 5:00 Fax: (843) 454-7675 PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No Optometry Pack, Mark MD Johnson, David OD Provider ID: 1168395 Provider ID: TPVJOHN34-01 Gender: Male Gender: Male Mcleod Surgery Cheraw Marlboro Eye Care 1076 Marlboro Way, Ste 6 602 East Main Street Bennettsville, SC 29512-2495 Bennettsville, SC 29512 (843) 454-7677 (843) 479-2020 Fax: (843) 454-7675 Fax: (843) 454-2020 Mon - Fri 9:00 to 5:00 Mon - Thu 8:00 to 5:00 PCMH: No Fri 8:00 to 12:00 PCMH: No Internal Medicine Orthopaedic Surgery Santana Alarcon, Lhissa MD Provider ID: 770647 Carter, Ralph MD Gender: Female Provider ID: 918440 Marlboro Clinic Corp Gender: Male 1138 Cheraw St Orthocarolina Pa Bennettsville, SC 29512-2466 1007 Cheraw St (843) 454-8400 Bennettsville, SC 29512-2422 Mon - Fri 9:00 to 5:00 (843) 479-8357 PCMH: No Fax: (999) 999-9999 PCMH: No Obstetrics/Gynecology Rush, Paul MD Hoffman, Michael MD Provider ID: 928514 Provider ID: 1162575 Gender: Male Gender: Male Orthocarolina Pa Mcleod Ob Gyn Bennettsville 1007 Cheraw St 1040 Marlboro Way, Ste 7 Bennettsville, SC 29512-2422 Bennettsville, SC 29512-2494 (843) 479-8357 (843) 777-9140 PCMH: No Fax: (843) 777-9141 Mon - Fri 8:30 to 5:00 PCMH: No Smid, John MD Provider ID: 1428733 Gender: Male Orthocarolina Pa 1007 Cheraw St Bennettsville, SC 29512-2422 (843) 479-8357 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 123 38642781

Specialty Physicians Williamsburg Allergy & Immunology Gastroenterology - cont. Nephrology Magera, Barbara MD Bickerstaff, Charles MD Singh, Inderpal MD Provider ID: 1327267 Provider ID: 1441376 Provider ID: 1528193 Gender: Female Gender: Male Gender: Male Williamsburg Regional Specilaty Williamsburg Regional Specilaty Williamsburg Regional Health Cen Cen Center 500 Thur Marshall Hwy, Ste A 500 Thurgood Marshall Hwy, Ste A 500 Thurgood Marshall Highway, Kingstree, SC 29556-4027 Kingstree, SC 29556-4027 Ste F (843) 355-0201 (843) 355-0201 Kingstree, SC 29556 Fax: (843) 355-0123 Fax: (843) 355-0123 (843) 355-8888 Mon - Thu 8:30 to 5:00 Mon - Thu 8:30 to 5:00 Fax: (843) 355-9944 Fri 8:30 to 12:00 Fri 8:30 to 12:00 Mon - Fri 9:00 to 5:00 PCMH: No PCMH: No PCMH: No

Cardiology General Surgery Singh, Inderpal MD Provider ID: 1528193 Lieberman, Ariane MD Asaro, Joseph MD Gender: Male Provider ID: 1229187 Provider ID: 1229196 Williamsburg Regional Specialty Gender: Female Gender: Male Cen Willimasburg Regional Health Williamsburg Regional Hospital 500 Thurgood Marshall Hwy, Ste A Center 500 Nelson Blvd Kingstree, SC 29556-4143 500 Thurgood Marshall Highway, Kingstree, SC 29556 (843) 355-0201 Ste F (843) 365-8888 Fax: (843) 355-0123 Kingstree, SC 29556 Fax: (843) 355-9994 Mon - Fri 8:30 to 5:00 (843) 355-8888 Mon - Fri 8:00 to 5:00 PCMH: No Fax: (843) 355-9994 PCMH: No Williamsburg Regional Hospital Obstetrics/Gynecology Tidelands Waccamaw Community Rimkus, Gilbertas MD Hospital Provider ID: 772133 Tollison, Steven MD Mon - Fri 9:00 to 5:00 Gender: Male Provider ID: 2329388 PCMH: No Williamburg Regional Hospital Gender: Male 500 Nelson Blvd Hopehealth Kingstree Gastroenterology Kingstree, SC 29556 520 Thur Marshall Hwy, Ste B (843) 355-8888 Kingstree, SC 29556-4108 Bickerstaff, Charles MD Mon - Fri 9:00 to 5:00 (843) 355-5628 Provider ID: 1441376 PCMH: No Fax: (843) 355-5616 Gender: Male Mon - Fri 7:30 to 5:00 Willimasburg Regional Health PCMH: No Center Internal Medicine 500 Thurgood Marshall Highway, Natarajan, Sundar MD Optometry Ste F Provider ID: 2287996 Kingstree, SC 29556 Gender: Male Johnson, Edward OD (843) 355-8888 Williamsburg Regional Hospital Provider ID: TPVJOHN37-01 Fax: (843) 355-9994 500 Nelson Blvd Gender: Male Mon - Fri 9:00 to 5:00 Kingstree, SC 29556-4027 Edward Johnson PCMH: No (843) 355-0175 409 Martin Luther King Boulevard Fax: (843) 355-0115 Kingstree, SC 29556 Mon - Sun 12:00 to 12:00 (843) 355-2020 PCMH: No Fax: (843) 355-2028 Mon, Wed, Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 124 38642781

Specialty Physicians Williamsburg Orthopaedic Surgery Psychology Skinner, Wright MD Leith-Fischer, Madeleine SS Provider ID: 1821579 Gender: Male Provider ID: 2070843 Williamsburg Orthopedics Gender: Female 402 Nelson Blvd, Ste 400 Live Oak Psycho Educational Kingstree, SC 29556-4058 Service (843) 355-0201 402 Nelson Blvd, Ste 10 Fax: (843) 355-0123 Kingstree, SC 29556-4058 Mon - Thu 8:30 to 5:00 (843) 457-0138 Fri 8:30 to 12:00 Mon - Tue 9:30 to 3:00 PCMH: No PCMH: No

Podiatry Thoracic Surgery Butterworth, Michelle DPM Smith III, Charlie MD Provider ID: 1525754 Provider ID: 452064 Gender: Female Gender: Male Williamsburg Foot Center Williamsburg Regional Hospital 500 Thurgood Marshall Hwy, Ste B 500 Nelson Blvd Kingstree, SC 29556-4143 Kingstree, SC 29556 (843) 355-0255 (843) 365-8888 Fax: (843) 355-0259 Fax: (843) 355-9994 Mon, Thu 10:00 to 12:00 Mon - Sun 12:00 to 12:00 Tue 10:00 to 5:00 PCMH: No Wed 3:00 to 5:00 Fri 9:00 to 5:00 Smith III, Charlie MD PCMH: No Provider ID: 452064 Gender: Male Butterworth, Michelle DPM Williamsburg Surgical Group Provider ID: 771536 500 Thur Marshall Hwy, Ste G Gender: Female Kingstree, SC 29556-4143 Pee Dee Foot Center (843) 355-0180 402 Nelson Blvd, Ste 300 Fax: (843) 355-1606 Kingstree, SC 29556 Mon - Fri 8:30 to 5:00 (843) 355-9690 PCMH: No Fax: (843) 355-9777 Mon, Thu 10:00 to 12:00 Urology Tue 10:00 to 5:00 Wed 3:00 to 5:00 Wright, David MD Fri 9:00 to 5:00 Provider ID: 1120738 PCMH: No Gender: Male Williamsburg Regional Rural Health Corey, Stephen DPM 500 Thur Marshall Hwy, Ste F Provider ID: 772016 Kingstree, SC 29556-4143 Gender: Male (843) 355-1772 Pee Dee Foot Center Fax: (843) 355-1775 402 Nelson Blvd, Ste 300 Mon - Fri 9:00 to 5:00 Kingstree, SC 29556 PCMH: No (843) 355-9690 Fax: (843) 355-9777 Mon - Wed, Fri 9:00 to 5:00 Thu 2:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 125 38642781

Hospitals Chesterfield Hospital Mcleod Health Cheraw Provider ID: 1129434 711 Chesterfield Hwy Cheraw, SC 29520 (843) 623-5665 Mon - Sun 12:00 to 12:00

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Hospitals Darlington Hospital Carolina Pines Regional Medical Center Provider ID: 771058 1304 W Bobo Newsom Hwy Hartsville, SC 29550 (843) 339-4100 Mon - Sun 12:00 to 12:00

Mcleod Medica Center Darlington Provider ID: 770460 701 Cashua Ferry Rd Darlington, SC 29532 (843) 777-1100 Fax: (843) 777-1146 Mon - Sun 12:00 to 12:00

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Hospitals Dillon Hospital Mcleod Medical Center Dillon Provider ID: 774293 301 E Jackson St Dillon, SC 29536 (843) 774-4111 Fax: (843) 774-1563 Mon - Sun 12:00 to 12:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 128 38642781

Hospitals Florence Hospital Lake City Community Hospital Provider ID: 775898 258 N Ron Mcnair Blvd Lake City, SC 29560 (843) 374-2036 Fax: (843) 374-5111 Mon - Sun 12:00 to 12:00

Mcleod Regional Medical Center Provider ID: 770375 555 E Cheves St Florence, SC 29501 (843) 777-2000 Fax: (843) 777-7554 Mon - Sun 12:00 to 12:00

Musc Health Florence Medical Center Provider ID: 771518 805 Pamplico Hwy Florence, SC 29505-6047 (843) 674-2500 Fax: (843) 674-2519 Mon - Sun 12:00 to 12:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 129 38642781

Hospitals Horry Hospital Conway Medical Center Provider ID: 990517 300 Singleton Ridge Rd Conway, SC 29526-9142 (843) 347-8075 Fax: (843) 347-8048 Mon - Fri 9:00 to 5:00

Grand Strand Regional Medical Center Provider ID: 770446 809 82nd Pkwy Myrtle Beach, SC 29572-4611 (803) 692-1100 Mon - Sun 12:00 to 12:00

Mcleod Loris Seacoast Ho Provider ID: 675182 3655 Mitchell St Loris, SC 29569 (843) 777-4424 Fax: (843) 777-5249 Mon - Sun 12:00 to 12:00

Mcleod Loris Seacoast Ho Provider ID: 675182 4000 Highway 9 E Little River, SC 29566-7833 (843) 777-4424 Fax: (843) 777-5249 Mon - Fri, Sun 12:00 to 12:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 130 38642781

Hospitals Marion Hospital Musc Health Marion Medical Center Provider ID: 912086 2829 E Highway 76 Mullins, SC 29574-6035 (843) 431-2000 Fax: (843) 431-2414 Mon - Sun 12:00 to 12:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 131 38642781

Hospitals Williamsburg Hospital Williamsburg Regional Hospital Provider ID: 772796 500 Nelson Blvd Kingstree, SC 29556 (843) 355-8888 Fax: (843) 355-9994 Mon - Sun 12:00 to 12:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 132 38642781

Ancillary Providers All Laboratory Pathology Testing Labcorp For Providers And Locations Please Call: (888) 522-2677

Quest Diagnostics For Providers And Locations Please Call: (888) 277-8772

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 133 38642781

Ancillary Providers Chesterfield Behavioral Health Facility Durable Medical Equipment Kershaw County Commission On Bridges And Jamesinc Wanna- Alcohol And maker Drug Provider ID: 806460 Provider ID: 920029 The Alpha Center Bridges And Jamesinc DBA Wanna- 1218 East Blvd make Chesterfield, SC 29709-5148 154 Market St (843) 623-7062 Cheraw, SC 29520-2412 Fax: (843) 623-7112 (843) 537-3221 Mon - Fri 8:30 to 5:00 Fax: (843) 537-9550 Mon - Fri 8:30 to 6:00 Sc Department Of Juvenile Justice Sat 8:30 to 1:00 Provider ID: 1297764 Federally Qualified Health Center 101 Main St Chesterfield, SC 29709-1703 Biester, Christina MD (803) 896-9477 Provider ID: 769529 Fax: (803) 896-5646 Csc Chesterfield Mon - Fri 8:30 to 5:00 Subspecialty: HRSA FQHC 500 West Blvd Chesterfield, SC 29709-1402 The Alpha Behavioral Health (843) 623-5080 Center Fax: (843) 623-5081 Provider ID: 1223919 Mon - Fri 8:30 to 5:00 1218 East Blvd Chesterfield, SC 29709 Sandhills Med Foundation (843) 623-7062 Provider ID: 831116 Fax: (843) 623-7112 645 S Seventh St Mon - Fri 8:30 to 5:00 Mc Bee, SC 29101 (843) 335-8291 Community Health Center Fax: (843) 335-8731 Mon - Fri 9:00 to 5:00 Chesterfield County Health Department Provider ID: 773527 Sc Dhec - Bureau Of Finance 203 N Page St Chesterfield, SC 29709 (803) 898-0784 Mon - Fri 9:00 to 5:00

Dialysis Pageland Dialysis Provider ID: 773863 505a S Pearl St Pageland, SC 29728-2222 (843) 672-3491 Fax: (843) 672-3504 Mon - Sat 5:30 to 6:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 134 38642781

Ancillary Providers Darlington Behavioral Health Facility Fmc Dialysis Svcs Hartsville Provider ID: 874116 No Bounds Care Inc Fmc Dialysis Hartsville Provider ID: 1225625 1308 S 4th St 405 Pine St Hartsville, SC 29550 Darlington, SC 29532 (843) 383-9526 (803) 237-2273 Fax: (843) 383-9577 Mon - Fri 9:00 to 5:00 Mon - Fri 9:00 to 5:00

Sc Department Of Juvenile Justice Fresenius Kidney Care Black Creek Dialys Provider ID: 1297764 Provider ID: 1714097 302 Russell St, Room 15 Fresenius Kidney Care Black Creek Darlington, SC 29532-3307 D (803) 896-9477 1001 S 4th St Fax: (803) 896-5646 Hartsville, SC 29550-5791 Mon - Fri 8:30 to 5:00 (843) 332-2355 Fax: (843) 332-8994 Community Health Center Mon, Wed, Fri 8:00 to 3:00 Darlington County Health Depart- ment Harts Dialysis Provider ID: 772656 Provider ID: 972932 Sc Dhec - Bureau Of Finance 1015 S 4th St 305 Russell St Hartsville, SC 29550-5791 Darlington, SC 29532 (843) 332-5688 (843) 398-4400 Fax: (843) 332-1039 Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 4:00

Community Mental Health Center Durable Medical Equipment Pee Dee Mental Health Center Palmetto Breathing Solutions Provider ID: 1240052 Provider ID: 777350 Pee Dee Darlington County Clinic 18 Public Sq 900 S 4th St Darlington, SC 29532 Hartsville, SC 29550-5787 (843) 393-1001 (843) 332-4141 Fax: (843) 398-0020 Fax: (843) 383-4625 Mon - Fri 9:00 to 5:00 Mon - Tue, Fri 8:30 to 5:00 Wed - Thu 8:30 to 7:00 Orthotics & Prosthetics Palmetto Prosthetics And Dialysis Orthotics Inc Darlington Dialysis Ctr Provider ID: 1061536 Provider ID: 874617 Palmetto Prosthetics And Orthotics Darlington Dialysis 701 Medical Park Dr, Ste 106 103 Saleeby Loop Hartsville, SC 29550-4777 Darlington, SC 29532 (843) 332-3291 (843) 393-1682 Fax: (843) 673-0333 Fax: (843) 393-1685 Tue 1:00 to 5:00 Mon - Fri 9:00 to 5:00 Wed 9:00 to 5:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 135 38642781

Ancillary Providers Dillon Behavioral Health Facility Durable Medical Equipment Family First Support Center Lincare Inc Provider ID: 1783327 Provider ID: 378045 Family First Support Center Inc 1115 Highway 301 N, Ste A 411 W Hampton St Dillon, SC 29536-2498 Dillon, SC 29536-3337 (842) 774-7444 (843) 765-4087 Fax: (843) 774-7479 Fax: (843) 765-4085 Mon - Fri 8:00 to 5:00 Mon - Fri 9:00 to 5:00 Sleep Diagnostic Studies Sc Department Of Juvenile Justice Carolina Sleep Diagnostics Inc Provider ID: 1297764 Provider ID: 777378 200 S 5th Ave 200 W Harrison St, Ste B Dillon, SC 29536-3332 Dillon, SC 29536 (803) 896-9477 (843) 841-1220 Fax: (803) 896-5646 Fax: (843) 841-2062 Mon - Fri 8:30 to 5:00 Mon - Fri 8:00 to 4:30

Trinity Behavioral Care Provider ID: 805275 204 N Mlk Jr Blvd Dillon, SC 29536 (843) 774-6591 Fax: (843) 774-1409 Mon - Fri 8:30 to 5:00

Community Health Center Dillon County Health Department Provider ID: 770401 Sc Dhec - Bureau Of Finance 201 W Hampton St Dillon, SC 29536 (843) 774-5611 Mon - Fri 9:00 to 5:00

Dialysis Fresenius Med Care Dillon Provider ID: 875551 Dillon Dialysis 1304 Highway 301 S Dillon, SC 29536 (843) 774-3687 Fax: (843) 774-3688 Mon - Fri 9:00 to 5:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 136 38642781

Ancillary Providers Florence Ambulatory Surgery Center Behavioral Health Facility Community Health Center Florence Surgery And Laser Circle Park Behavioral Health Florence County Health Depart- Center LLC Services ment Provider ID: 859517 Provider ID: 2234870 Provider ID: 774921 Florence Surgery And Laser Center Circle Park Behavioral Health Servi Florence County Hlth Dept L 238 S Coit St 145 E Cheves St 400 N Cashua Dr Florence, SC 29501-4422 Florence, SC 29506-2526 Florence, SC 29501-2098 (843) 665-9349 (843) 661-4835 (843) 664-9393 Fax: (843) 669-6122 Mon - Fri 9:00 to 5:00 Fax: (843) 664-2301 Mon - Fri 8:00 to 5:00 Mon - Thu 6:30 to 4:30 Community Mental Health Center Growing Home Southeast Mcleod Cardiothoracic Vascular Pee Dee Mental Health Center Provider ID: 1213326 Provider ID: 1240052 Surgical 181 East Evans St Btc-120, Ste D15 125 E Cheves St Provider ID: 770613 Florence, SC 29506 Florence, SC 29506-2526 Mcleod Physician Associates (803) 664-2010 (843) 317-4089 101 S Ravenel St, Ste 270 Fax: (803) 432-6685 Fax: (843) 317-4096 Florence, SC 29506 Mon - Fri 8:30 to 5:00 Mon - Tue, Fri 8:30 to 5:00 (843) 664-0220 Wed - Thu 8:30 to 7:00 Fax: (843) 664-9545 Life Altering Behavioral Health Mon - Thu 8:00 to 4:30 Services Fri 8:00 to 2:30 Pee Dee Mental Health Center Provider ID: 1219370 Provider ID: 1240052 Life Altering Behavioral Health Ser Pee Dee Lake City Clinic Mcleod Cardiothoracic Vascular 1354 Celebration Blvd, Ste B 675 N Matthews Rd Surgical Florence, SC 29501 Lake City, SC 29560-7027 Provider ID: 770613 (843) 407-6734 (843) 394-4882 Mcleod Physician Associates Fax: (855) 710-8085 Fax: (843) 394-2603 305 E Cheves St, Ste 230 Mon - Fri 8:30 to 5:30 Mon - Tue, Fri 8:30 to 5:00 Florence, SC 29506-2611 Wed - Thu 8:30 to 7:00 (843) 777-3850 Positive Influences Inc Fax: (843) 665-8908 Provider ID: 1223921 Diagnostic Center Mon - Fri 9:00 to 5:00 2716 W Palmetto St, Ste 4 Florence, SC 29501 Musc Health Lake City Imaging Audiology (843) 799-5235 Center Fax: (843) 799-5290 Provider ID: 1727955 Burrows, Dennis PHD Mon - Fri 9:00 to 5:00 Musc Health Lake City Imaging Provider ID: 772581 Cent Pee Dee Speech Hearing Center Sc Department Of Juvenile Justice 148 Sauls St, Ste F 153 E N B Baroody St Lake City, SC 29560-2677 Florence, SC 29506 Provider ID: 1297764 (843) 699-9440 (843) 662-7802 180 N Irby St Mon - Fri 8:00 to 5:00 Fax: (843) 662-5601 Florence, SC 29501-3456 Mon - Fri 8:30 to 5:00 (803) 896-9477 Fax: (803) 896-5646 Mon - Fri 8:30 to 5:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 137 38642781

Ancillary Providers Florence Diagnostic Imaging Fresenius Kidney Care Florence Childrens Care Pharmacy Provider ID: 773803 Inmed Diagnostic Services Of Sc Medical M Provider ID: 1654017 1530 Mclure Ct LLC 181 E Evans St, Ste B Florence, SC 29505 Provider ID: 957027 Florence, SC 29506-5503 (843) 679-1881 Inmed Diagnostic Services Of Sc Ll (843) 679-0550 Fax: (843) 679-1887 1120 W Evans St Fax: (843) 679-0599 Mon - Fri 9:00 to 5:00 Florence, SC 29501-3320 Mon, Wed, Fri 6:00 to 8:00 (843) 292-0082 Fax: (803) 292-0086 Crossway Medical Mon - Fri 7:00 to 5:00 Fresenius Med Care Church St Provider ID: 771197 Provider ID: 871685 1412 Pamplico Hwy Fmc Church St Florence, SC 29505 Palmetto Imaging Inc DBA 406 S Church St (843) 292-8797 Florence MRI Florence, SC 29506 Mon - Fri 8:30 to 5:00 Provider ID: 1755335 (843) 664-3074 Florence MRI And Imaging Mon - Fri 9:00 to 5:00 Hanger Clinic 805 S Irby St Provider ID: 134894 Florence, SC 29501-5236 Fresenius Med Care Florence Hanger Prosthetic & Orthotics Inc (843) 292-0400 Dialysis D Fax: (843) 292-0470 326 South Dargan Street Mon - Fri 8:00 to 6:00 Provider ID: 875044 Florence Dialysis Ctr Florence, SC 29506-2537 435 N Cashua Dr (843) 669-8509 Dialysis Florence, SC 29501 Mon - Fri 9:00 to 5:00 Fmc Dialysis Pee Dee Dialysis Ctr (843) 669-0825 Provider ID: 876909 Fax: (843) 665-6343 Hanger Prosthetics & Orthotics Fmc Dialysis Pee Dee Mon - Fri 9:00 to 5:00 331 Elizabeth Anne Ct Provider ID: 914015 Lake City, SC 29560 Fresenius Med Care Johnsonville 326 S Dargan St (843) 394-3944 Provider ID: 877435 Florence, SC 29506-2537 Fax: (843) 394-1683 200 Stuckey St (843) 669-8509 Mon - Fri 9:00 to 5:00 Johnsonville, SC 29555 Fax: (843) 667-3590 (843) 380-1581 Mon - Fri 9:00 to 5:00 Fmc Freedom Dialysis Fax: (843) 380-1753 Provider ID: 876013 Mon - Fri 9:00 to 5:00 K J Pharmacy 129 Florence Freedom Provider ID: 1323111 1520 Freedom Blvd Kelley Corners Dialysis K J Pharmacy 129 Florence, SC 29505 Provider ID: 2324194 240 Kelley St (843) 667-0654 231 Kelley St Lake City, SC 29560 Fax: (843) 292-9489 Lake City, SC 29560-2446 (843) 374-1110 Mon - Fri 9:00 to 5:00 (843) 394-3847 Fax: (843) 374-1117 Fax: (843) 394-3966 Mon - Fri 8:00 to 7:00 Sat 8:00 to 5:00 Fresenius Kidney Care Florence Mon, Wed, Fri 6:00 to 1:00 Home Durable Medical Equipment Lincare Provider ID: 1982888 Provider ID: 776604 1465 Pamplico Hwy A1 Medical 2325 Prosperity Way Florence, SC 29505-6173 Provider ID: 770917 Florence, SC 29501 (843) 667-6223 2659 Tv Rd (843) 669-7900 Fax: (843) 667-9670 Florence, SC 29501 Fax: (843) 669-7904 Mon - Sat 5:00 to 6:00 (843) 661-2166 Mon - Fri 9:00 to 5:00 Fax: (843) 679-5655 Mon - Fri 9:00 to 5:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 138 38642781

Ancillary Providers Florence Durable Medical Equipment - cont. Palmetto Infusion Services Florence Visiting Nurses Service Provider ID: 2135063 Lincare Inc Inc 161 Dozier Blvd, Ste 110 Provider ID: 770977 Provider ID: 378045 Florence, SC 29501 2325 Prosperity Way Co Atlantic Homecare Inc (800) 809-1265 1605 W Palmetto St Florence, SC 29501-0831 Mon - Fri 8:00 to 5:00 (843) 669-7900 Florence, SC 29502 Fax: (843) 669-7904 (843) 667-1515 Mon - Fri 8:00 to 5:00 Palmetto Infusion Services LLC Fax: (843) 667-0076 Mon - Fri 8:30 to 5:00 Provider ID: 856547 Linkia Palmetto Infusion Services Loving Arms Home Care LLC Provider ID: 769903 161 Dozier Blvd, Ste 100 326 S Dargan St Provider ID: 1575948 Florence, SC 29501-4026 608 Gregg Ave, Ste 202 Florence, SC 29506-2537 (800) 809-1265 (843) 669-8509 Florence, SC 29501-4317 Fax: (843) 584-8502 (843) 879-4837 Fax: (843) 667-3590 Mon - Fri 8:00 to 5:00 Mon - Fri 9:00 to 5:00 Fax: (704) 862-6777 Mon - Sat 8:00 to 5:00 Pharmacy Express LLC Low Country Home Medical Provider ID: 1496221 Infusion Therapy Equipment Co In 2803 W Palmetto St Provider ID: 956369 Florence, SC 29501 Palmetto Infusion Services Low Country Home Medical Equip- (843) 665-2066 ment Fax: (843) 665-5128 Provider ID: 2135063 1947 Hoffmeyer Rd, Ste A Mon - Fri 9:00 to 5:00 161 Dozier Blvd, Ste 110 Florence, SC 29501-3935 Florence, SC 29501 (843) 662-3043 Tucker Wells Medical Inc (800) 809-1265 Mon - Fri 8:00 to 5:00 Provider ID: 773425 Mon - Fri 8:00 to 5:00 198 E Cheves St Lowcountry Pharmacy Florence, SC 29506 Palmetto Infusion Services LLC Provider ID: 775246 (843) 665-2092 Lowcountry Pharmacy LLC Fax: (843) 665-5205 Provider ID: 856547 1530 Mclure Ct Mon - Fri 9:00 to 5:00 Palmetto Infusion Services Florence, SC 29505-6174 161 Dozier Blvd, Ste 100 Florence, SC 29501-4026 (843) 656-2973 Home Health Care Fax: (843) 656-2978 (800) 809-1265 Mon - Fri 9:00 to 5:00 Florence Home Care Services LLC Fax: (843) 584-8502 Mon - Fri 8:00 to 5:00 Medi Home Care Provider ID: 2087527 Provider ID: 777060 Carolinas Home Health Professional Pharmacy Services 2391 David H Mcleod Blvd, Ste B 1945 W Palmetto St, Ste 405 Inc Florence, SC 29501-3934 Florence, SC 29501-3919 Provider ID: 775949 (843) 667-0906 (843) 629-6811 2213 W Palmetto St Fax: (843) 667-0918 Fax: (843) 629-6870 Florence, SC 29501 Mon - Fri 9:00 to 5:00 Mon - Wed, Fri 8:00 to 4:30 (843) 665-4051 Thu 8:00 to 4:34 Fax: (843) 665-4786 Palmetto Diabetic Center Mon - Fri 8:00 to 5:00 Provider ID: 1173521 211 S Jones Rd, Ste B Olanta, SC 29114 (843) 396-9730 Fax: (843) 396-9735 Mon - Fri 9:00 to 5:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 139 38642781

Ancillary Providers Florence Laboratory Pathology Testing Regional Health Testing Center Rehabilitation Facility Doctors Care LLC Healthpro Heritage Rehab And Provider ID: TPV117888-01 Provider ID: TPV67578-01 Fitness LLC 2200 S Irby St 376 W. Palmetto St, Ste 1 Florence, SC 29501 Provider ID: 2393195 Florence, SC 29505 Healthpro Heritage Rehab And (843) 662-9945 (843) 799-0642 Fax: (843) 799-0933 Fitnes Fax: (843) 662-9946 718 S Dargan St Florence, SC 29506-2561 Regional Health Testing Center Doctors Care (864) 536-4667 Provider ID: TPV67768-01 LLC Fax: (864) 968-0266 2410 Hoffmeyer Rd Provider ID: TPV3739871-01 Mon - Fri 8:00 to 5:00 Florence, SC 29501 376 W. Palmetto St, Ste 1 (843) 662-8182 Florence, SC 29501 Healthsouth Rehabilitation Fax: (843) 662-8183 (843) 799-0642 Fax: (843) 799-0933 Hospital Of F Provider ID: 972517 Executor Diagnostics LLC Healthsouth Rehabilitation Center I Provider ID: 772273 Orthotics & Prosthetics 900 E Cheves St 1929a Mountain Laurel Ct Florence Brace And Limb Inc Florence, SC 29506-2704 Florence, SC 29505 Provider ID: 1310621 (843) 679-9000 (843) 292-1112 2293 S Irby St Fax: (843) 678-3754 Fax: (843) 292-1118 Florence, SC 29505 Mon - Sun 12:00 to 12:00 Mon - Fri 9:00 to 5:00 (843) 665-1102 Fax: (843) 799-5097 Sleep Diagnostic Studies Labcorp Mon - Fri 9:00 to 5:00 Provider ID: TPV1476305-01 Carolina Sleep Diagnostics Inc Provider ID: 777378 1508a N Cashua Dr Hanger Clinic Florence, SC 29501 2724 W Palmetto St, Ste 12 (843) 679-0687 Provider ID: 134894 Florence, SC 29501 Fax: (843) 669-8328 Hanger Prosthetic & Orthotics Inc (843) 678-8998 D Fax: (843) 678-8999 326 South Dargan Street Mon - Fri 9:00 to 5:00 Labcorp Florence, SC 29506-2537 Provider ID: TPV1476306-01 (843) 669-8509 711 Saluda Dr Mon - Fri 9:00 to 5:00 Palmetto Sleep Lab LLC Florence, SC 29501 Provider ID: 941998 Palmetto Sleeplab LLC (843) 665-2030 Palmetto Prosthetics And Fax: (843) 665-9616 2724 West Palmetto Street, Ste 12 Orthotics Inc Florence, SC 29501-4909 Provider ID: 770059 (843) 651-2624 Laboratory Corp Of America Palmetto Prosthetics And Orthotics Fax: (843) 491-4023 Provider ID: 103935 451 W Cheves St Mon - Fri 9:00 to 4:00 1508 N Cashua Dr, Ste A Florence, SC 29501 Florence, SC 29501-6970 (843) 673-9222 Speech Therapy (843) 679-0687 Fax: (843) 673-0333 Mon - Fri 9:00 to 5:00 Mon - Fri 8:30 to 5:00 Mcleod Regional Medical Center Laboratory Corp Of America Provider ID: 772899 Provider ID: 103935 555 E Cheves St 901 E Cheves St Florence, SC 29501 Florence, SC 29506-2773 (843) 777-4422 (843) 667-1891 Mon - Fri 9:00 to 5:00 Mon - Fri 9:00 to 5:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 140 38642781

Ancillary Providers Horry Ambulatory Surgery Center Horry County Commission On Waccamaw Crs Alcohol Drug Provider ID: 772950 Grande Dunes Surgery Center Bureau Of Finance - Scdhec Provider ID: 771800 Provider ID: 805616 Womens Recovery Center 2830 Oak St 1021 Cipriana Dr, Ste 100 Conway, SC 29526-4560 Myrtle Beach, SC 29572 901 Bell St Conway, SC 29526-4113 (803) 898-0784 (843) 449-7885 Fax: (803) 898-0613 Mon - Fri 9:00 to 5:00 (843) 488-1300 Fax: (843) 488-1330 Mon - Fri 9:00 to 5:00 Mon - Fri, Sun 12:00 to 12:00 Parkway Surgery Center LLC Community Mental Health Center Provider ID: 918806 Sc Department Of Juvenile Justice 827 82nd Pkwy Waccamaw Center For Mental Myrtle Beach, SC 29572-4607 Provider ID: 1297764 Health (843) 286-2020 1201 3rd Ave, Ste 107 Provider ID: 1240063 Fax: (843) 286-2030 Conway, SC 29526-5105 164 Waccamaw Medical Park Dr Mon - Thu 7:00 to 4:30 (803) 896-9477 Conway, SC 29526-8903 Fri 7:00 to 3:30 Fax: (803) 896-5646 (843) 347-5060 Mon - Fri 8:30 to 5:00 Fax: (843) 347-4102 Rivertown Surgery Center Mon - Fri 8:30 to 5:00 Provider ID: 776947 South Carolina Youth Advocate 822 Farrar Dr Convenient Care Clinic Conway, SC 29526-8747 Program (843) 347-9587 Provider ID: 1219364 Minuteclinic Diagnostic South Mon - Fri 9:00 to 5:00 South Carolina Youth Advocate Carolina Progr Provider ID: 804188 148 Elk Dr, Unit 4 Strand Gastrointestinal Endo- Minuteclinic Diagnostic Of Sc LLC Murrells Inlet, SC 29576 1010 Highway 17 N scopy Center (843) 238-9691 North Myrtle Beach, SC 29582-2806 Provider ID: 770356 Fax: (843) 238-4588 (866) 389-2727 Strand Gastrointestinal Endoscopy Mon - Fri 9:00 to 5:00 Fax: (401) 652-9093 C Mon - Fri 8:30 to 7:30 945 82nd Pkwy, Ste 2 South Carolina Youth Advocate Sat 9:00 to 5:30 Myrtle Beach, SC 29572 Sun 10:00 to 5:30 (843) 839-2581 Program Mon - Fri 9:00 to 5:00 Provider ID: 1219364 South Carolina Youth Advocate Minuteclinic Diagnostic South Progr Behavioral Health Facility Carolina 604 Gregg Ave Provider ID: 804188 Horry County Commission On Murrells Inlet, SC 29576 Minuteclinic Diagnostic Of Sc LLC (843) 661-7080 Alcohol Drug 1303 38th Ave N Fax: (843) 667-4737 Myrtle Beach, SC 29577-1315 Provider ID: 805616 Mon - Fri 9:00 to 5:00 Shoreline Bhs (866) 389-2727 2404 Wise Rd Fax: (401) 652-9093 Conway, SC 29526-5521 Community Health Center Mon - Fri 8:30 to 7:30 Sat 9:00 to 5:30 (843) 365-8884 Horry County Health Department Fax: (843) 365-7164 Sun 10:00 to 5:30 Mon - Wed 8:00 to 8:30 Provider ID: 774775 Thu - Fri 8:00 to 5:00 Sc Dhec - Bureau Of Finance 1804 Main St Conway, SC 29526 (843) 248-1500 Mon - Fri 9:00 to 5:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 141 38642781

Ancillary Providers Horry Convenient Care Clinic - cont. Minuteclinic Diagnostic South Minuteclinic LLC Provider ID: 1129577 Minuteclinic Diagnostic South Carolina Provider ID: 808026 Minuteclinic In Cvs/Pharmacy Carolina Conway 2996 E Highway 501 Provider ID: 804188 2996 E Highway 501 Conway, SC 29526-9532 Minuteclinic Diagnostic Of Sc LLC Conway, SC 29526-9532 (866) 389-2727 3710 Highway 17 (866) 389-2727 Fax: (401) 216-3854 Murrells Inlet, SC 29576-5005 Fax: (401) 652-9093 Mon - Fri 8:30 to 7:30 (866) 389-2727 Mon - Fri 8:30 to 7:30 Sat 9:00 to 5:30 Fax: (401) 652-9093 Sat 9:00 to 5:30 Sun 10:00 to 5:30 Mon - Fri 8:30 to 7:30 Sun 10:00 to 5:30 Sat 9:00 to 5:30 Sun 10:00 to 5:30 Minuteclinic LLC Minuteclinic LLC Provider ID: 1129577 Provider ID: 1129577 Minuteclinic In Cvs/Pharmacy Minuteclinic Diagnostic South Minuteclinic In Cvs/Pharmacy 3411 Socastee Blvd Carolina 3710 Highway 17, Corner Of Hwy Myrtle Beach, SC 29588-6111 Provider ID: 808026 707 (866) 389-2727 1010 Highway 17 N Murrells Inlet, SC 29576-5005 Fax: (401) 216-3854 North Myrtle Beach, SC 29582-2806 (866) 389-2727 Mon - Fri 8:30 to 7:30 (866) 389-2727 Fax: (401) 216-3854 Sat 9:00 to 5:30 Fax: (401) 652-9093 Mon - Fri 8:30 to 7:30 Sun 10:00 to 5:30 Mon - Fri 8:30 to 7:30 Sat 9:00 to 5:30 Sat 9:00 to 5:30 Sun 10:00 to 5:30 Diagnostic Center Sun 10:00 to 5:30 Tidelands Health Imaging Minuteclinic LLC Minuteclinic Diagnostic South Provider ID: 1756386 Provider ID: 1129577 Tidelands Health Imaging At Long Carolina Minuteclinic In Cvs/Pharmacy Provider ID: 808026 Ba 1010 Highway 17 N 900 21st Ave N 1303 38th Ave N North Myrtle Beach, SC 29582-2806 Myrtle Beach, SC 29577-1315 Myrtle Beach, SC 29577-7483 (866) 389-2727 (843) 916-1700 (866) 389-2727 Fax: (401) 216-3854 Fax: (401) 652-9093 Fax: (843) 916-9460 Mon - Fri 8:30 to 7:30 Mon - Fri 8:30 to 5:00 Mon - Fri 8:30 to 7:30 Sat 9:00 to 5:30 Sat 9:00 to 5:30 Sun 10:00 to 5:30 Sun 10:00 to 5:30 Diagnostic Imaging Minuteclinic LLC Inmed Diagnostic Services Of Sc Minuteclinic Diagnostic South Provider ID: 1129577 LLC Carolina Minuteclinic In Cvs/Pharmacy Provider ID: 957027 Provider ID: 808026 1303 38th Ave N In Med Diagnostic Services Of Sc Ll 3710 Highway 17, Corner Of Hwy Myrtle Beach, SC 29577-1315 4701 Oleander Dr, Ste C 707 (866) 389-2727 Myrtle Beach, SC 29577-5762 Murrells Inlet, SC 29576-5005 Fax: (401) 216-3854 (843) 692-0040 (866) 389-2727 Mon - Fri 8:30 to 7:30 Fax: (843) 692-0046 Fax: (401) 652-9093 Sat 9:00 to 5:30 Mon - Fri 9:00 to 5:00 Mon - Fri 8:30 to 7:30 Sun 10:00 to 5:30 Sat 9:00 to 5:30 Sun 10:00 to 5:30

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 142 38642781

Ancillary Providers Horry Diagnostic Imaging - cont. Fresenius Med Care West Conway Durable Medical Equipment Provider ID: 876422 Tidelands Health Imaging Fmc West Conway Aerocare Provider ID: 2215116 1702 Mill Pond Rd Provider ID: 772601 Tidelands Health Imaging At The Conway, SC 29527 3930 Wesley St Mar (843) 488-0328 Myrtle Beach, SC 29579 2200 Crow Lane, Ste 103 Fax: (843) 488-0348 (843) 236-7776 Myrtle Beach, SC 29577-1663 Mon - Fri 9:00 to 5:00 Fax: (843) 236-7774 (843) 848-5101 Mon - Fri 9:00 to 5:00 Fax: (843) 848-5105 Mon - Fri 8:30 to 5:00 Longs Dialysis Provider ID: 770475 American Homepatient 90 Cloverleaf Dr Provider ID: 787601 Dialysis Longs, SC 29568-9262 4209 Mayfair St, Ste B (843) 399-5275 Myrtle Beach, SC 29577 Conway Dialysis Ctr (843) 839-1649 Provider ID: 876039 Fax: (843) 399-5314 Mon - Fri 9:00 to 5:00 Fax: (843) 839-1699 838 Farrar Dr Mon - Fri 8:30 to 5:00 Conway, SC 29526 (843) 347-5111 Longs Dialysis Fax: (843) 347-4811 Provider ID: 811265 Apria Healthcare LLC Mon - Fri 9:00 to 5:00 90 Cloverleaf Dr, Ste 306 Provider ID: 772318 Longs, SC 29568-9262 3558b Old Kings Hwy (843) 399-5275 Murrells Inlet, SC 29576-6367 Fmc Dialysis Svcs Murrells Inlet (843) 357-3520 Provider ID: 874089 Fax: (843) 399-5314 Mon, Wed, Fri 6:00 to 10:00 Fax: (843) 357-3530 Murrells Inlet Dialysis Mon - Fri 8:30 to 5:00 5011 Hwyy 17 Byp Sat - Sun 12:00 to 12:00 Murrells Inlet, SC 29576 Loris Dialysis Ctr (843) 357-4840 Provider ID: 873728 Fax: (843) 357-8144 3827 Bell St Bailey, Byron MD Mon - Fri 9:00 to 5:00 Loris, SC 29569 Provider ID: 1191173 (843) 756-0300 Roper St Francis Physician Partners Fmc Dialysis Svcs N Myrtle Beach Fax: (843) 756-0027 4823 Hwy 17 N, Ste B Mon - Fri 9:00 to 5:00 Murrells Inlet, SC 29576-5037 Provider ID: 874219 (843) 723-8823 Fmc Dialysis North Myrtle Fax: (843) 766-6551 710 Highway 17 S, Ste A Market Commons Dialysis Center North Myrtle Beach, SC 29582 Mon - Fri 9:00 to 5:00 (843) 361-1709 Provider ID: 1158278 Fax: (843) 361-7930 1350 Farrow Pkwy, Ste 100 Cape Fear Orthotics & Prosthetics Mon - Fri 9:00 to 5:00 Myrtle Beach, SC 29577-1668 (843) 839-0966 Provider ID: 932356 Fresenius Med Care Myrtle Beach Fax: (843) 839-0977 Cape Fear Orthotics And Prostetics Mon, Wed, Fri 4:30 to 4:30 2100 Old Highway 17 N, Ste 102 Provider ID: 875523 North Myrtle Beach, SC 29582-2242 Fmc Myrtle Beach (843) 249-2500 4592 Oleander Dr Myrtle Beach Dialysis Fax: (843) 249-2544 Myrtle Beach, SC 29577 Provider ID: 771934 Mon - Fri 8:00 to 5:00 (843) 839-2855 3919 Mayfair St Fax: (843) 839-8256 Myrtle Beach, SC 29577-5773 Mon - Fri 9:00 to 5:00 (877) 678-8603 Carolina Care Medical Supply LLC Fax: (843) 448-4930 Mon - Sat 6:00 to 7:00 Provider ID: 771825 3152 W Highway 501 Conway, SC 29526 (843) 365-2273 Fax: (843) 369-2267 Mon - Fri 9:00 to 5:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 143 38642781

Ancillary Providers Horry Durable Medical Equipment - cont. Gluzberg, Tatyana MD Lincare Inc Provider ID: 1190796 Provider ID: 378045 Cuddy, Brian MD Roper St. Francis Physician Partner 1644 Dividend Loop Provider ID: 1190713 4959 Highway 17 Myrtle Beach, SC 29577-1876 Roper St Francis Physician Partners Murrells Inlet, SC 29576-5041 (843) 445-9997 4823 Hwy 17 N, Ste B (843) 357-1299 Fax: (843) 445-9838 Murrells Inlet, SC 29576-5037 Fax: (843) 357-2264 Mon - Fri 8:00 to 5:00 (843) 723-8823 Mon - Fri 9:00 to 5:00 Fax: (843) 766-6551 Mon - Fri 9:00 to 5:00 Lincare Inc Gluzberg, Tatyana MD Provider ID: 378045 Provider ID: 1190799 4209 Mayfair St, Ste B Express Medical Equipment Inc Roper St. Francis After Hours Care- Myrtle Beach, SC 29577 Provider ID: 777073 912 Inlet Square Dr, Ste A (843) 839-1649 195 Prather Park Dr, Unit 2 Murrells Inlet, SC 29576-7812 Fax: (843) 839-1699 Myrtle Beach, SC 29588 (843) 357-1299 Mon - Fri 8:30 to 5:00 (843) 283-3863 Fax: (843) 651-1047 Fax: (843) 236-4271 Mon - Fri 9:00 to 5:00 Mon - Fri 9:00 to 5:00 Lincare Inc Provider ID: 378045 Incare Medical Equipment Myrtle American Home Patient Family Care Medical Supply 1301 48th Ave N, Ste C Provider ID: 772625 Beach Provider ID: 775707 Myrtle Beach, SC 29577-5427 4251 Main St (843) 839-1613 Loris, SC 29569 Medi Home Care 4711 Highway 17 Byp S Fax: (843) 839-1699 (843) 756-6869 Mon - Fri 9:00 to 5:00 Fax: (843) 756-6890 Myrtle Beach, SC 29577-6693 Mon - Fri 9:00 to 5:00 (843) 293-2122 Fax: (843) 293-4009 Lincare Inc Mon - Fri 8:00 to 5:00 Provider ID: 378045 Firilas, Anthony MD Coastal Home Care Provider ID: 1190761 1400 Highway 544 Roper St Francis Physician Partners Khoury, George MD Provider ID: 1190883 Conway, SC 29526-8445 4630 Highway 17 (843) 347-0711 Murrells Inlet, SC 29576-5016 Roper St Francis Physician Partners 4823 Hwy 17 N, Ste B Fax: (843) 347-0833 (843) 958-1281 Mon - Fri 8:30 to 5:00 Fax: (843) 958-1278 Murrells Inlet, SC 29576-5037 Mon - Fri 9:00 to 5:00 (843) 723-8823 Fax: (843) 766-6551 Palmetto Infusion Services Myrtle Mon - Fri 9:00 to 5:00 First Choice Medical Respiratory Beach Provider ID: 771717 Servic Lincare Palmetto Infusion Services Myrtle B Provider ID: 772396 Provider ID: 776604 317 Hinson Drive First Choice Medical Respiratory S 1644 Dividend Loop Myrtle Beach, SC 29579-4435 3357 Casey St Myrtle Beach, SC 29577-1876 (843) 839-2550 Loris, SC 29569 (843) 445-9997 Fax: (843) 839-2555 (843) 756-4300 Fax: (843) 445-9838 Mon - Fri 8:00 to 5:00 Fax: (843) 756-0811 Mon - Fri 9:00 to 5:00 Mon - Fri 9:00 to 5:00 Reliable Medical Of Conway LLC Lincare Inc Provider ID: 810692 Provider ID: 378045 Reliable Medical Of Conway 723 Seaboard St 2381 Highway 544, Unit 1 Myrtle Beach, SC 29577-6511 Conway, SC 29526-9232 (888) 461-3116 (303) 905-8527 Fax: (303) 663-7109 Mon - Fri 8:30 to 5:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 144 38642781

Ancillary Providers Horry Durable Medical Equipment - cont. Worthington, Ward MD Grady, Cynthia MD Provider ID: 1191155 Provider ID: 1981735 Rotech Roper St Francis Physician Partners Health Care Partners Of South Provider ID: 328392 4823 Hwy 17 N, Ste B Carol American Health Services Murrells Inlet, SC 29576-5037 1608 Main St 11692 Bypass 17 (843) 723-8823 Conway, SC 29526-3572 Murrells Inlet, SC 29576 Fax: (843) 766-6551 (843) 248-4700 (843) 357-1691 Mon - Fri 9:00 to 5:00 Mon - Sat 8:00 to 5:00 Fax: (843) 357-8808 Mon - Fri 8:30 to 5:30 Worthington, Ward MD Koike, Jun MD Provider ID: 1191155 Provider ID: 1720902 Ruonala Durable Medical Equip- Roper St. Francis Physician Partner Health Care Partners Of South ment 4835 Hwy 17 N Bypass, Ste B Carol Provider ID: 771448 Murrells Inlet, SC 29576-5037 1608 Main St 423 Main St (843) 723-8823 Conway, SC 29526-3572 North Myrtle Beach, SC 29582 Fax: (843) 766-6551 (843) 248-4700 (877) 674-4671 Mon - Fri 9:00 to 5:00 Mon - Thu 8:00 to 5:00 Mon - Fri 9:00 to 5:00 Fri 8:00 to 12:00 Wright, Lisa MD Steichen, John MD Provider ID: 1334445 Little River Medical Center Provider ID: 1191096 Roper St. Francis Physician Partner Provider ID: 829918 Roper St. Francis Physician Partner 4959 Highway 17 7724 N Kings Hwy 4835 Hwy 17 N Bypass, Ste B Murrells Inlet, SC 29576-5041 Myrtle Beach, SC 29572 Murrells Inlet, SC 29576-5037 (843) 357-1299 (843) 839-3939 (843) 723-8823 Fax: (843) 357-2264 Mon - Fri 9:00 to 5:00 Fax: (843) 766-6551 Mon - Fri 5:00 to 9:00 Mon - Fri 9:00 to 5:00 Sat 8:00 to 4:00 Norton, Laura PHD Provider ID: 1139001 Stuart, Robert MD Federally Qualified Health Center Little River Medical Center Inc Provider ID: 1191097 4303 Live Oak Dr Roper St Francis Physician Partners Chaum, Edward MD Little River, SC 29566-9138 4823 Hwy 17 N, Ste B Provider ID: 1337348 (843) 663-8000 Murrells Inlet, SC 29576-5037 Little River Medical Center Inc Fax: (843) 663-8123 (843) 723-8823 3236 Holmestown Rd, Ste E1 Mon - Fri 8:30 to 4:30 Fax: (843) 766-6551 Myrtle Beach, SC 29588 Mon - Fri 9:00 to 5:00 (843) 663-8000 Fax: (843) 663-8092 Taylor, Laura MD Mon - Fri 8:30 to 5:30 Provider ID: 2202873 The Mobility Center Of The Little River Medical Center Inc Grand Strand 4220 Carolina Exchange Dr Provider ID: 929111 Chaum, Edward MD Myrtle Beach, SC 29579-4220 The Mobility Center Of The Grand Provider ID: 1337348 (843) 663-8000 St Little River Medical Center Inc Mon - Fri 8:30 to 5:30 7831 N Kings Hwy 7726 N Kings Hwy Sat - Sun 8:00 to 6:00 Myrtle Beach, SC 29572-6054 Myrtle Beach, SC 29572 (843) 692-8001 (843) 663-8000 Fax: (843) 449-9858 Fax: (843) 663-8258 Mon - Fri 9:00 to 5:00 Mon - Fri 8:30 to 5:30

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 145 38642781

Ancillary Providers Horry Federally Qualified Health Center - Toman, Jordan MD Infusion Therapy cont. Provider ID: 1596165 Little River Medical Center Inc Palmetto Infusion Services Myrtle Taylor, Laura MD 4303 Live Oak Dr Beach Provider ID: 2202873 Little River, SC 29566-9138 Provider ID: 771717 Little River Medical Center Inc (843) 663-8000 Palmetto Infusion Services Myrtle B 4303 Live Oak Dr Fax: (843) 663-3303 317 Hinson Drive Little River, SC 29566-9138 Mon - Fri 8:30 to 5:30 Myrtle Beach, SC 29579-4435 (843) 663-8000 (843) 839-2550 Fax: (843) 663-8123 Home Health Care Fax: (843) 839-2555 Mon - Fri 8:30 to 5:30 Mon - Fri 8:00 to 5:00 Sat 9:00 to 1:00 Incare Home Health Sun 8:00 to 6:00 Provider ID: 777229 Laboratory Pathology Testing 106 Highway 17 S, Sundial Center Taylor, Laura MD North Myrtle Beach, SC 29582 Labcorp Provider ID: 2202873 (843) 280-4148 Provider ID: TPV1476312-01 Little River Medical Center Inc Fax: (843) 280-6978 812 Farrar Dr Ste A 7724 N Kings Hwy Mon - Fri 9:00 to 5:00 Conway, SC 29526 Myrtle Beach, SC 29572-3041 (843) 347-8480 (843) 663-8000 Incare Home Health Fax: (843) 347-8489 Mon - Fri 8:30 to 5:30 Provider ID: 777229 1261 E Highway 501 Labcorp Taylor, Laura MD Conway, SC 29526-8965 Provider ID: TPV1476313-01 Provider ID: 2202873 (843) 347-6418 1021 Cipriana Drive Ste 260 Little River Medical Inc Fax: (843) 347-6430 Myrtle Beach, SC 29572 3817 Main St Mon - Fri 9:00 to 5:00 (843) 497-6726 Loris, SC 29569-3017 Fax: (843) 497-5770 (843) 663-8000 Incare Home Health Mon - Fri 8:30 to 5:30 Provider ID: 777229 Quest Diagnostics 164 Waccamw Med Park Ct, Ste B Provider ID: TPV118088-01 Taylor, Laura MD Conway, SC 29526 909 Medical Cir Provider ID: 2202873 (843) 347-6418 Myrtle Beach, SC 29572 Little River Medical Center Inc Fax: (843) 347-6430 (843) 449-4897 1075 Mr Joe White Ave, Unit 101 Mon - Fri 9:00 to 5:00 Fax: (843) 449-4529 Myrtle Beach, SC 29577-5658 (843) 663-8000 Incare Home Health Quest Diagnostics Mon - Fri 8:30 to 5:30 Provider ID: 777229 Provider ID: TPV287767-01 Sat - Sun 8:00 to 6:00 4682 Highway 17 S 909 Medical Cir Myrtle Beach, SC 29577 Myrtle Beach, SC 29572 Taylor, Laura MD (843) 293-4614 (866) 697-8378 Provider ID: 2202873 Fax: (843) 293-6336 Fax: (843) 449-4529 Little River Medical Center Inc Mon - Fri 9:00 to 5:00 3236 Holmestown Rd, Unit E1 Quest Diagnostics Myrtle Beach, SC 29588-7495 Incare Home Health Provider ID: TPV66314-01 (843) 663-8000 Provider ID: 777229 909 Medical Cir Ste 909 Mon - Fri 8:30 to 5:30 4685 Highway 17 Byp S Myrtle Beach, SC 29572 Myrtle Beach, SC 29577-6681 (866) 697-8378 (843) 293-4614 Fax: (843) 449-4529 Fax: (843) 293-5030 Mon - Fri 9:00 to 5:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 146 38642781

Ancillary Providers Horry Laboratory Pathology Testing - cont. Carolina Orthotics And Pros- Conway Manor thetics LLC Provider ID: 967394 Solstas Quest Diagnostics 3300 4th Ave Provider ID: TPV118038-01 Provider ID: 770576 Carolina Orthotics And Prosthetics Conway, SC 29527-6002 660 Singleton Ridge Rd, Suite B (843) 248-5728 Conway, SC 29528 1294 Professional Dr, Ste B Myrtle Beach, SC 29577-5753 Fax: (843) 248-6698 (843) 347-4416 Mon - Sun 12:00 to 12:00 Fax: (843) 347-4422 (843) 497-9558 Fax: (843) 497-9130 Mon - Fri 9:00 to 5:00 Sleep Diagnostic Studies Solstas Quest Diagnostics Provider ID: TPV360016-01 Coastal Sleep Lab Inc 660 Singleton Ridge Rd, Ste B Floyd Brace Company Inc Provider ID: 1224351 Conway, SC 29528 Provider ID: 921764 4420 Oleander Dr, Ste 105 (842) 347-4416 164 Waccamaw Medical Park Ct, Ste Myrtle Beach, SC 29577 B (843) 455-9700 Conway, SC 29526-8965 Orthotics & Prosthetics Fax: (843) 946-9460 (843) 234-0627 Mon - Sun 8:00 to 7:00 Thu 9:00 to 12:00 A Perfect Fit Provider ID: 774759 Lyons Prosthetics And Orthotics Coastal Sleep Lab Inc 7719 N Kings Hwy Provider ID: 1224351 Myrtle Beach, SC 29572 Coastal Sleep Lab (843) 692-2555 Provider ID: 776096 123 Waccamaw Medical Park Dr 1570 Highway 9 E Fax: (843) 692-9976 Longs, SC 29568 Mon - Fri 9:00 to 5:00 Conway, SC 29526 (843) 347-5800 (843) 399-3900 Mon - Fri 9:00 to 5:00 Fax: (843) 399-3901 Carolina Orthotics And Prosthetic Mon - Sun 8:00 to 7:00 Of Myr Physical Therapy Provider ID: 773551 Palmetto Sleep Lab LLC Carolina Orthotics And Prosthetic Cora South Carolina Provider ID: 941998 O Provider ID: 2204917 Palmetto Sleeplab LLC 9714 N Kings Hwy, Ste 142 11931 Plaza Dr 1087 Redi Mix Rd Myrtle Beach, SC 29572 Murrells Inlet, SC 29576-9356 Little River, SC 29566-7132 (843) 497-9558 (843) 357-4039 (843) 444-0800 Fax: (843) 497-9130 Fax: (843) 357-4227 Fax: (843) 444-0881 Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 Mon - Fri 9:00 to 4:00

Carolina Orthotics And Pros- Skilled Nursing Facility Palmetto Sleep Lab LLC thetics LLC Provider ID: 941998 Provider ID: 770576 Carolina Healthcare Inc DBA Palmetto Sleeplab LLC Carolina Orthotics And Prosthetics Compass Post 1601 N Oak St, Ste 309 11871 Plaza Dr, Unit 6 Provider ID: 1048233 Myrtle Beach, SC 29577-3579 Murrells Inlet, SC 29576-7450 Compass Post Acute Rehabilitation (843) 808-0800 (843) 651-5347 2320 Highway 378 Fax: (843) 357-1471 Fax: (843) 651-3451 Conway, SC 29527-4911 Mon - Fri 9:00 to 4:00 Mon - Fri 9:00 to 5:00 (843) 397-2273 Fax: (843) 397-0854 Palmetto Sleep Lab LLC Mon - Sun 12:00 to 12:00 Provider ID: 941998 Palmetto Sleeplab LLC 243 Singleton Ridge Rd, Ste D Conway, SC 29526-8391 (843) 444-0800 Fax: (843) 357-1471 Mon - Fri 9:00 to 4:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 147 38642781

Ancillary Providers Horry Sleep Diagnostic Studies - cont. Palmetto Sleep Lab LLC Provider ID: 941998 Palmetto Sleeplab LLC 4959 Highway 17, Unit A Murrells Inlet, SC 29576-5041 (843) 444-0800 Fax: (843) 444-0881 Mon - Fri 9:00 to 4:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 148 38642781

Ancillary Providers Marion Behavioral Health Facility Momentum Medical Brace And Sc Department Of Juvenile Justice Limb Provider ID: 772130 Provider ID: 1297764 2876 W Hwy 76 1305 N Main St, Pob 1094 Mullins, SC 29574 Marion, SC 29571-1094 (843) 423-2337 (803) 896-9477 Fax: (843) 423-2338 Fax: (803) 896-5646 Mon - Fri 9:00 to 5:00 Mon - Fri 8:30 to 5:00 Federally Qualified Health Center Community Health Center Burke, Valerie MD Marion County Health Depart- Provider ID: 776707 Health Care Partners Of Sc ment 145 Palmetto Pointe Rd Provider ID: 776743 Marion, SC 29571 Sc Dhec - Bureau Of Finance (843) 248-4700 206 Airport Ct, Ste B Mon - Fri 9:00 to 5:00 Mullins, SC 29574 (843) 423-8295 Mon - Fri 9:00 to 5:00 Laboratory Pathology Testing Marion County Medical Center Community Mental Health Center Provider ID: TPV118238-01 2829 E Highway 76 Pee Dee Mental Health Center Mullins, SC 29574 Provider ID: 1240052 (843) 431-2550 Pee Dee Marion County Clinic 1100 S Main St Marion, SC 29571-4914 Marion County Medical Center (843) 431-1100 Provider ID: TPV67516-01 Fax: (843) 431-1103 2829 E Highway 76 Mon - Tue, Fri 8:30 to 5:00 Mullins, SC 29574 Wed - Thu 8:30 to 7:00 (843) 431-2550

Dialysis Skilled Nursing Facility Fresenius Med Care Marion Musc Health Mullins Nursing Provider ID: 874088 Center Marion Dialysis Provider ID: 924124 109 Merritt Ct 518 S Main St Marion, SC 29571 Mullins, SC 29574 (843) 423-4673 (843) 464-8211 Fax: (843) 423-4675 Fax: (843) 464-1330 Mon - Fri 9:00 to 5:00 Mon - Sun 12:00 to 12:00

Durable Medical Equipment Lincare Inc Provider ID: 378045 401 N Main St Marion, SC 29571-3029 (843) 431-9340 Fax: (843) 431-9342 Mon - Fri 8:00 to 5:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 149 38642781

Ancillary Providers Marlboro Behavioral Health Facility Durable Medical Equipment Sc Department Of Juvenile Justice Fowler Pharmacy Provider ID: 1171583 Provider ID: 1297764 301 E Market St 205 E Market St Bennettsville, SC 29512 Bennettsville, SC 29512-0453 (843) 479-3831 (803) 896-9477 Fax: (843) 747-9383 Fax: (803) 896-5646 Mon - Fri 9:00 to 6:00 Mon - Fri 8:30 to 5:00 Skilled Nursing Facility Community Health Center Dundee Manor Marlboro County Health Depart- Provider ID: 964183 ment 710 Hwy 15-401 By-Pass West Provider ID: 771174 Bennettsville, SC 29512 Sc Dhec - Bureau Of Finance (843) 479-6251 711 S Parsonage St Fax: (843) 479-8101 Bennettsville, SC 29512 Mon - Sun 12:00 to 12:00 (843) 479-6801 Mon - Fri 9:00 to 5:00

Community Mental Health Center Tri County Mental Health Provider ID: 1243211 Tricounty Mental Health 1035 Cheraw St Bennettsville, SC 29512-2422 (843) 454-0841 Fax: (846) 454-0635 Mon - Fri 8:30 to 5:00

Dialysis Fresenius Med Care Bennettsville Provider ID: 877006 Fmc Bennettsville Dialysis 1104 Frank W Evans Way Bennettsville, SC 29512 (843) 479-3817 Fax: (843) 479-3819 Mon - Fri 9:00 to 5:00

Mccoll Dialysis Provider ID: 970668 3595 Highway 15-401 E Mc Coll, SC 29570-5918 (843) 523-6274 Fax: (843) 523-5418 Mon, Wed, Fri 5:00 to 6:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 150 38642781

Ancillary Providers Williamsburg Behavioral Health Facility Community Mental Health Center Lincare Inc Provider ID: 378045 Sc Department Of Juvenile Justice Waccamaw Center For Mental American Homepatient Health 331 W Mill St Provider ID: 1297764 Provider ID: 1240063 Kingstree, SC 29556-3236 209 Short St, Pob 697 Waccamaw Neighborhood Family (843) 354-7090 Kingstree, SC 29556-3926 Center Fax: (843) 354-9050 (803) 896-9477 314 E Main St Mon - Fri 9:30 to 3:30 Fax: (803) 896-5646 Kingstree, SC 29556-3513 Sat - Sun 12:00 to 12:00 Mon - Fri 8:30 to 5:00 (843) 354-5524 Fax: (843) 354-7318 Laboratory Pathology Testing Williamsburg County Department Mon - Fri 8:30 to 5:00 On Alchol Laboratory Corp Of America Provider ID: 806952 Waccamaw Center For Mental Provider ID: 103935 Light House Health 1075 N Fraser St, Ste A 301 N Main St Provider ID: 1240063 Hemingway, SC 29554-9190 Hemingway, SC 29554 Williamsburg Clinic (843) 520-1973 (843) 355-9113 501 Nelson Blvd Mon - Fri 9:00 to 5:00 Mon - Tue 8:30 to 7:00 Kingstree, SC 29556-4026 Wed - Fri 8:30 to 5:00 (843) 354-5453 Laboratory Corp Of America Fax: (843) 354-3322 Provider ID: 103935 Williamsburg County Department Mon - Fri 8:30 to 5:00 456 N Main St, Ste A On Alchol Hemingway, SC 29554-9190 Provider ID: 806952 Dialysis (845) 558-1150 Williamsburg County Department Mon - Fri 9:00 to 5:00 On A Fresenius Med Care Kingstree 115 Short St Provider ID: 876501 Kingstree, SC 29556-3924 Kingstree Dialysis (843) 355-9113 215 N Brooks St Mon - Thu 8:30 to 7:00 Kingstree, SC 29556 Fri 8:30 to 5:00 (843) 355-9750 Mon - Fri 9:00 to 5:00 Community Health Center Durable Medical Equipment Williamsburg County Health American Homepatient Department Provider ID: 775454 Provider ID: 772497 331 W Mill St Sc Dhec - Bureau Of Finance Kingstree, SC 29556-3236 520 Thurgood Marshall Hwy (843) 354-7090 Kingstree, SC 29556 Fax: (843) 354-9050 (843) 355-6012 Mon - Fri 9:30 to 3:30 Mon - Fri 9:00 to 5:00 Sat - Sun 12:00 to 12:00

Drucker Drugs And Medical Equipment Provider ID: 776663 110 E Main St Kingstree, SC 29556 (843) 354-9582 Fax: (843) 354-6080 Mon - Fri 9:00 to 5:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 151 38642781

Allied Providers Chesterfield Family Practice Evans, Patricia LPC Nurse Practitioner Family Medicine Provider ID: 1404004 Canipe, Karen APRN Gender: Female Bennett, Meagan APRN Provider ID: 1040690 Highly Favored LLC Provider ID: 1648859 Gender: Female 102 Duvall St Gender: Female Palmetto Family Medicine Of Cheraw, SC 29520 Palmetto Family Medicine Of Chester (843) 865-7268 Chester 316 2nd St Fax: (910) 920-9165 316 2nd St Cheraw, SC 29520-2404 Mon - Thu 8:00 to 6:00 Cheraw, SC 29520-2404 (843) 921-4851 PCMH: No (843) 921-4851 Fax: (843) 921-4854 Fax: (843) 921-4854 Mon - Thu 8:00 to 5:00 Mon, Wed - Thu 8:00 to 5:00 Fri 8:00 to 1:00 Evans, Patricia LPC Tue 9:00 to 5:00 PCMH: No Provider ID: 1404004 Fri 8:00 to 1:00 Gender: Female PCMH: No Highly Favored LLC Licensed Clinical Social Worker 65 Sanders Ln Nurse Practitioner Gerentology Rhyne, Jack LCSW Cheraw, SC 29520 Provider ID: 925897 (843) 865-7005 Cooper, Janet APRN Gender: Male Fax: (910) 920-9165 Provider ID: 1599178 Caresouth Carolina PCMH: No Gender: Female 500 West Blvd Agape Senior Primary Care Inc DBA Chesterfield, SC 29709-1402 Wallace, Panora LPC L (843) 623-5080 Provider ID: 993221 206 S Gum St Fax: (843) 623-5081 Gender: Female Pageland, SC 29728-2304 Mon - Fri 8:30 to 5:00 Panora Z Wallace (843) 672-5930 PCMH: No 308 Airport Ln, Apt 4 Fax: (843) 353-2581 Cheraw, SC 29520-8564 Mon - Fri 8:00 to 5:00 Licensed Professional Counselor (803) 422-9095 PCMH: No Fax: (803) 609-6777 Banda, Darlinda LPC Mon - Fri 10:00 to 6:00 Pediatrics Provider ID: 1348095 PCMH: No Gender: Female Atkinson, Meredith APRN Recovery Behavioral Healthcare Nurse Practitioner Adult Health Provider ID: 1058726 LLC Gender: Female 416 West Blvd, Ste 4 Cooper, Janet APRN Mcleod Pediatrics Cheraw Chesterfield, SC 29709 Provider ID: 1599178 723 S Doctors Dr (843) 623-5647 Gender: Female Cheraw, SC 29520-7108 Fax: (843) 507-1024 Agape Senior Primary Care Inc DBA (843) 537-9360 Mon - Fri 9:00 to 5:00 L Fax: (843) 537-2756 PCMH: No 206 S Gum St Mon - Fri 8:00 to 5:00 Pageland, SC 29728-2304 PCMH: No Etheridge, Martin LPC (843) 672-5930 Provider ID: 1165872 Fax: (843) 353-2581 Professional Counselor Gender: Male Mon - Fri 8:00 to 5:00 Elite Community Counseling LLC PCMH: No Ellison, Beatrice LPC 120 N Pearl St Provider ID: 1692253 Pageland, SC 29728 Gender: Female (803) 207-7463 Integrated Care Services Fax: (843) 695-7931 110 Duvall St Mon - Fri 4:30 to 8:00 Cheraw, SC 29520-2406 Sat 11:00 to 2:30 (803) 692-1383 PCMH: No Mon - Fri 8:00 to 6:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 152 38642781

Allied Providers Darlington Audiology Caldwell, Alice APRN Andrews, Jeri APRN Provider ID: 1254795 Provider ID: 767916 Kirby, Lesley AUD Gender: Female Gender: Female Provider ID: 1000556 Pee Dee Health Care Caresouth Carolina Inc Gender: Female 301 W Main St, Lamar Subspecialty: HRSA FQHC Lifetime Hearing Services Lamar, SC 29069 1268 S 4th St, Ste A 754 W Carolina Ave (843) 395-8410 Hartsville, SC 29550-0703 Hartsville, SC 29550-4412 Fax: (843) 395-8401 (843) 332-3422 (843) 309-9230 Mon, Wed 2:00 to 4:30 Fax: (843) 332-3985 Fax: (843) 662-4327 Thu - Fri 7:30 to 4:30 Mon - Fri 8:30 to 5:00 Mon - Fri 8:30 to 5:00 PCMH: No PCMH: No PCMH: No Crawford, Anita APRN Licensed Clinical Social Worker Family Practice Provider ID: 1304738 Boyer, Jocelyn CSW Andrews, Jeri APRN Gender: Female Hartsville Medical Associates LLC Provider ID: 2060689 Provider ID: 767916 Gender: Female Gender: Female 206 Swift Creek Rd Hartsville, SC 29550 Caresouth Carolina Inc. Caresouth Carolina Inc 1268 S 4th St Subspecialty: HRSA FQHC (843) 917-4117 Fax: (843) 917-4590 Hartsville, SC 29550-0703 1268 S 4th St, Ste A (843) 332-3422 Hartsville, SC 29550-0703 Mon - Fri 8:00 to 5:00 PCMH: No Fax: (843) 339-5518 (843) 332-3422 Mon - Fri 8:30 to 5:00 Fax: (843) 332-3985 PCMH: No Mon - Fri 8:30 to 5:00 Gainey, Shannon APRN PCMH: No Provider ID: 1218878 Gender: Female Kershner, Elizabeth LCSW Hartsville Medical Group Provider ID: 771267 Andrews, Jeri APRN Gender: Female Provider ID: 767916 701 Medical Park Dr, Ste 305 Hartsville, SC 29550-4779 Csc Society Hill Gender: Female 737 S Main St Caresouth Carolina Inc (843) 383-5191 Fax: (843) 656-1194 Society Hill, SC 29593-8972 Subspecialty: HRSA FQHC (843) 378-4501 1268 S 4th St, Ste A Mon - Fri 8:00 to 5:00 PCMH: No Fax: (843) 378-4209 Hartsville, SC 29550-0703 Mon - Fri 8:30 to 5:00 (843) 332-3422 PCMH: No Fax: (843) 332-3985 Federally Qualified Health Center Mon - Fri 8:30 to 5:00 PCMH: No Andrews, Jeri APRN Licensed Independent Social Worker Provider ID: 767916 Gender: Female Hood, Teresia LSW Barrett, Valorie APRN Caresouth Carolina Inc Provider ID: 1555443 Provider ID: 1257969 Subspecialty: HRSA FQHC Gender: Female Gender: Female 1268 S 4th St, Ste A No Bounds II Pee Dee Health Care Hartsville, SC 29550-0703 112 Court St 201 Cashua St (843) 332-3422 Darlington, SC 29532-5243 Darlington, SC 29532-3301 Fax: (843) 332-3985 (803) 327-2273 (843) 393-7452 Mon - Fri 8:30 to 5:00 Fax: (855) 345-0943 Fax: (843) 393-6210 PCMH: No Thu 10:00 to 2:00 Mon - Fri 8:00 to 5:00 Fri 9:00 to 12:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 153 38642781

Allied Providers Darlington Licensed Independent Social Worker Graham, Rochelle LPC Lynn, Deborah LPC - cont. Provider ID: 1037203 Provider ID: 1365744 Gender: Female Gender: Female Hood, Teresia LSW 1773 Shaw Dr Palmetto Counsleing Of Hartsville L Provider ID: 1645125 Hartsville, SC 29550-5943 5003 Una Rd Gender: Female (843) 992-6014 Hartsville, SC 29550 Ensure Health Services LLC Fax: (843) 353-2446 (843) 453-9985 324 Bacote St PCMH: No Fax: (843) 857-4437 Darlington, SC 29532-5606 Mon - Fri 8:30 to 5:00 (704) 438-9885 Graham, Rochelle LPC PCMH: No Fax: (855) 345-0943 Provider ID: 1037203 Mon - Wed 2:00 to 5:00 Gender: Female Lynn, Deborah LPC Fri 9:00 to 1:00 Hope Counseling And Consulting Provider ID: 901127 PCMH: No Serv Gender: Female 219 S 6th St Equine Intervention LLC Licensed Professional Counselor Hartsville, SC 29550 5003 Una Rd (843) 992-6014 Hartsville, SC 29550-1954 Burgess, Bradley LPC Fax: (843) 332-4557 (843) 453-9985 Provider ID: 1134838 Mon, Wed, Fri 10:00 to 2:00 Fax: (843) 857-4437 Gender: Male PCMH: No Mon - Fri 9:00 to 5:00 Caresouth Carolina Inc PCMH: No 737 S Main St Society Hill, SC 29593-8972 Graham, Martha LPC (843) 378-4501 Provider ID: 1557307 Pressley, Veronica LPC Fax: (843) 378-4209 Gender: Female Provider ID: 1442691 Mon - Fri 8:30 to 5:00 Palmetto Counseling Of Hartsville L Gender: Female PCMH: No 5003 Una Rd Veronica Pressley Hartsville, SC 29550-1954 537 W Bobo Newsome Hwy (843) 292-9256 Hartsville, SC 29550-4750 Dewitt, Melissa LPC Fax: (843) 851-4437 (843) 309-9340 Provider ID: 896909 Mon - Fri 8:30 to 5:00 Fax: (843) 309-9341 Gender: Female PCMH: No Mon - Fri 8:30 to 6:00 Serenity Counseling Place PCMH: No 708 Pearl Street Darlington, SC 29532 Kahn, David LPC (843) 393-2773 Provider ID: 1586438 Redfearn, Teresa LPC Fax: (843) 628-6649 Gender: Male Provider ID: 1836710 PCMH: No Peedee Healthcare Inc. Gender: Female 201 Cashua St Child And Family Resource Center Darlington, SC 29532-3301 718 S 4th St Gibson, Robin LPC (843) 393-7452 Hartsville, SC 29550-5724 Provider ID: 777390 Fax: (843) 395-8435 (843) 917-0495 Gender: Female Mon - Fri 8:00 to 5:00 Fax: (864) 751-4179 Caresouth Carolina PCMH: No Mon - Fri 9:00 to 5:00 1268 S 4th St, Ste A PCMH: No Hartsville, SC 29550-0703 (843) 332-3422 Kelley, Jill LPC Fax: (843) 332-3985 Provider ID: 1162992 Serafin, Jeremy LPC Mon - Fri 9:00 to 5:00 Gender: Female Provider ID: 1324008 PCMH: No Palmetto Counsleing Of Hartsville Gender: Male 5003 Una Rd Palmetto Counseling Of Hartsville Hartsville, SC 29550 5003 Una Rd (843) 307-4762 Hartsville, SC 29550 Fax: (843) 857-4437 (843) 453-9985 Mon - Fri 8:30 to 5:00 Fax: (843) 857-4437 PCMH: No Mon - Fri 8:00 to 8:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 154 38642781

Allied Providers Darlington Licensed Professional Counselor - Lowe, Ashley ARNP Fulwood, Karen APRN cont. Provider ID: 767351 Provider ID: 1271387 Gender: Female Gender: Female Wallace, Panora LPC Mcleod Family Medicine Of Pee Dee Health Care Provider ID: 993221 Darlingto 201 Cashua St Gender: Female 701 Cashua Ferry Rd Darlington, SC 29532-3301 576 W Carolina Ave Darlington, SC 29532 (843) 393-7452 Hartsville, SC 29550-5412 (843) 398-8500 Fax: (843) 393-6210 (843) 309-9340 Fax: (843) 391-2026 Mon - Fri 8:00 to 5:00 Fax: (843) 309-9341 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No Powell, Kimberly APRN Nurse Practitioner Trader, Andrea CNP Provider ID: 2163737 Provider ID: 776992 Gender: Female Caldwell, Alice CNP Gender: Female Hartsville Medical Associates Provider ID: 768503 The Medical Group 206 Swift Creek Rd Gender: Female 701 Medical Park Dr, Ste 305 Hartsville, SC 29550-4383 Pee Dee Health Care Hartsville, SC 29550 (843) 917-4117 201 Cashua St (843) 383-5191 Mon - Thu 8:00 to 5:00 Darlington, SC 29532 Fax: (843) 332-9229 Fri 8:00 to 12:00 (843) 393-7452 Mon - Fri 9:00 to 5:00 PCMH: No Fax: (843) 393-6210 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Simpson, Jada ARNP Wicker, Maryum APRN Provider ID: 1421880 Provider ID: 2047257 Gender: Female Carter, Shari CNP Gender: Female Ph Medical Group Midlands Provider ID: 773186 Mcleod Urgent Care Darlington 701 Medical Park Dr, Ste 301 Gender: Male 964 Lochend Dr Hartsville, SC 29550 Hartsville Medical Group LLC Darlington, SC 29532-5698 (843) 383-5978 701 Medical Park Dr, Ste 305 (843) 777-6890 Fax: (843) 383-5977 Hartsville, SC 29550-4779 Fax: (843) 777-6891 Mon - Thu 8:00 to 5:00 (843) 339-3040 Mon - Fri 8:00 to 8:00 Fri 8:00 to 1:00 Fax: (843) 383-0320 Sat - Sun 9:00 to 8:00 PCMH: No Carolina Pines Regional Medical PCMH: No Center Mon - Fri 9:00 to 5:00 Tedder, Tona APRN PCMH: No Nurse Practitioner Family Medicine Provider ID: 1830900 Gender: Female Bass, Morgan APRN Hartsville Medical Associates Johnson, Sharon APRN Provider ID: 2402373 206 Swift Creek Rd Provider ID: 1605436 Gender: Female Hartsville, SC 29550-4383 Gender: Female Genesis Healthcare Inc DBA Olanta (843) 917-4117 Sc House Calls Inc F Fax: (843) 917-4170 1131 E Home Ave, Carriage House Of 201 Cashua St Mon - Fri 8:00 to 5:00 Hartsville Darlington, SC 29532-3301 Sat 9:00 to 1:00 Hartsville, SC 29550-3411 (843) 396-9730 PCMH: No (843) 383-6990 Fax: (843) 396-9735 Fax: (843) 353-2581 Mon - Thu 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fri 8:00 to 12:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 155 38642781

Allied Providers Darlington Nurse Practitioner Family Medicine - Moore, Casey APRN Bledsoe, Keri OT cont. Provider ID: 1444002 Provider ID: 770182 Gender: Female Gender: Female Thompson, Angel APRN Morphis Pediatric Group Hartsville Developmental Therapy Solutions Provider ID: 1475205 708 Medical Park Dr 1482 Pocket Rd Gender: Female Hartsville, SC 29550-4765 Darlington, SC 29532 Genesis Health Care Inc. / Peedee (843) 332-5121 (843) 616-3597 201 Cashua St Fax: (843) 332-0993 Fax: (843) 393-4780 Darlington, SC 29532 Mon - Thu 8:30 to 8:00 Mon - Fri 8:00 to 5:00 (843) 393-7452 Fri 8:30 to 5:00 PCMH: No Fax: (843) 393-6210 Sat - Sun 9:00 to 11:00 Mon - Fri 8:00 to 5:00 PCMH: No Ingram, Irene OT PCMH: No Provider ID: 776586 Nurse Practitioner Psychiatric Gender: Female Woodward, Tracie APRN Mental Health Therapeutic Designs And Services Provider ID: 1605033 In Gender: Female Krozer, Steven APRN 603 W Carolina Ave Hometown Urgent Care LLC Provider ID: 1555446 Hartsville, SC 29550 305 W Bobo Newsom Hwy Gender: Male (843) 332-3600 Hartsville, SC 29550-4747 No Bounds II Fax: (843) 332-1314 (843) 309-3028 112 Court St Mon - Thu 8:00 to 6:00 Fax: (843) 309-3029 Darlington, SC 29532 Fri 9:00 to 5:00 Mon - Fri 8:00 to 8:00 (704) 258-6366 PCMH: No Sat 8:00 to 6:00 Fax: (855) 345-0943 Sun 12:00 to 6:00 Fri 10:00 to 2:00 Pediatrics PCMH: No PCMH: No Coward, Jacob APRN Nurse Practitioner Pediatric Obstetrics/Gynecology Provider ID: 768005 Gender: Male Jackson, Haley APRN George, Linda APRN Caring Hearts Pediatrics Provider ID: 1578946 Provider ID: 817437 518 E Carolina Ave, Ste B Gender: Female Gender: Female Hartsville, SC 29550-4312 The Children's Group P.c. Womens Care Of Hartsville (843) 383-4426 604 N 5th St 701 Medical Park Dr, Ste 202 Fax: (843) 383-8509 Hartsville, SC 29550-3212 Hartsville, SC 29550-4778 Carolina Pines Regional Medical (843) 332-6645 (843) 339-9222 Center Fax: (843) 332-9894 Fax: (843) 656-0102 Mon - Fri 8:00 to 5:00 Mon - Fri 8:30 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No Sat 9:00 to 11:00 PCMH: No PCMH: No Physical Therapy Occupational Therapy Mcleod, Casey APRN Shumate, Melissa PT Provider ID: 2265530 Blackwell, Joyce OT Provider ID: 776427 Gender: Female Provider ID: 776115 Gender: Female The Children's Group P.c. Gender: Female Omni Physical Therapy 604 N 5th St Developmental Therapy Solutions 1647 Ruby Rd Hartsville, SC 29550-3212 1482 Pocket Rd Hartsville, SC 29550 (843) 332-6645 Darlington, SC 29532 (843) 332-7750 Fax: (843) 332-9894 (843) 616-3597 Fax: (843) 332-7754 Mon - Fri 8:30 to 5:00 Fax: (843) 393-4780 Mon - Fri 8:00 to 5:00 Sat 9:00 to 11:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 156 38642781

Allied Providers Darlington Physician Assistant Reames, Danielle SLP Provider ID: 2083039 Oneal, Joseph PA Gender: Female Provider ID: 1302366 Therapuetic Designs Services Gender: Male 603 W Carolina Ave Palmetto Family Medicine And Hartsville, SC 29550-4443 Senio (843) 332-3600 420 W Carolina Ave Fax: (843) 332-1314 Hartsville, SC 29550 Mon - Thu 8:00 to 6:00 (843) 917-4968 PCMH: No Fax: (888) 854-0390 Mon - Fri 8:00 to 5:00 PCMH: No

Snapp, Isaac PA Provider ID: 1276037 Gender: Male Genesis Healthcare Inc DBA Pee Dee 201 Cashua St Darlington, SC 29532 (843) 393-7452 Fax: (843) 393-6210 Mon - Fri 8:00 to 5:00 PCMH: No

Psychiatry Tohid, Usman PA Provider ID: 960331 Gender: Male Mcleod Medical Center Darlington 701 Cashua Ferry Rd Darlington, SC 29532-8488 (843) 777-5246 Fax: (843) 777-5572 Mon - Sun 12:00 to 12:00 PCMH: No

Speech & Language Pathology Quinn, Elizabeth SLP Provider ID: 2398373 Gender: Female Therapeutic Designs And Services 603 W Carolina Ave Hartsville, SC 29550-4443 (843) 332-3600 Mon - Thu 8:00 to 6:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 157 38642781

Allied Providers Dillon Certified Nurse Anesthetist Harvey, Andre LCSW Nurse Practitioner Family Medicine Provider ID: 1611928 Torgersen, Keith CRNA Gender: Male Bethea, Orran APRN Provider ID: 2296215 Pinnacle Point Supportive Services Provider ID: 2115737 Gender: Male 311 W Harrison St Gender: Female Mcleod Medical Center Dillon Dillon, SC 29536-3311 Dillon Family Medicine P.a. 301 East Jackson St (843) 627-3308 603 N 6th Ave Dillon, SC 29536-2509 Fax: (800) 644-5523 Dillon, SC 29536-2503 (843) 777-5240 Mon - Fri 10:00 to 5:00 (843) 774-7336 Fax: (843) 777-5572 PCMH: No Mon - Thu 8:00 to 5:00 Mon - Sun 12:00 to 12:00 Fri 8:00 to 4:00 PCMH: No PCMH: No Licensed Professional Counselor Licensed Clinical Social Worker Fulmore, Carolyn LPC Britt, Loryn APRN Provider ID: 1841881 Provider ID: 2059921 Robinson, Allyson LCSW Gender: Female Gender: Female Provider ID: 1170492 Caresouth Carolina Inc Dillon Family Medicine Pa Gender: Female 122 Latimer St 603 N 6th Ave Pinnacle Point Supportive Services Latta, SC 29565-1828 Dillon, SC 29536-2503 311 W Harrison St (843) 627-6252 (843) 774-7336 Dillon, SC 29536-3311 Mon - Fri 8:30 to 5:00 Fax: (843) 774-7565 (843) 627-3308 PCMH: No Mon - Thu 8:00 to 5:00 Fax: (800) 644-5523 Fri 8:00 to 12:30 Mon - Fri 10:00 to 5:00 PCMH: No PCMH: No Nurse Practitioner Arnette, Caren APRN Dietz, Teresa APRN Teague, Daloria LCSW Provider ID: 1814044 Provider ID: 2060953 Provider ID: 1539254 Gender: Female Gender: Female Gender: Female Dillon Internal Medicine Associates Dillon Family Medicine Pa Pinnacle Point Supportive Services 705 N 8th Ave, Ste 1a 603 N 6th Ave 311 W Harrison St Dillon, SC 29536-2549 Dillon, SC 29536-2503 Dillon, SC 29536-3311 (843) 774-2478 (843) 777-7336 (843) 627-3308 Fax: (843) 774-0293 Fax: (843) 774-5656 Fax: (800) 644-5523 Mon - Thu 8:00 to 5:00 Mon - Thu 8:00 to 5:00 Mon - Fri 10:00 to 5:00 PCMH: No Fri 8:00 to 4:00 PCMH: No PCMH: No Carpenter, Lindsey APRN Licensed Independent Social Worker Provider ID: 1835564 Saxon, Angela APRN Gender: Female Provider ID: 1502234 Eddins, Stefani LCSW Pinnacle Point Supportive Services Provider ID: 1578941 Gender: Female 311 W Harrison St Mcleod Pediatrics Dillon Gender: Female Dillon, SC 29536-3311 Pinnacle Point Supportive Services 705 N 8th Ave, Ste 3a (843) 627-3308 Dillon, SC 29536-2549 311 W Harrison St Fax: (800) 644-5523 Dillon, SC 29536-3311 (843) 774-6091 Mon - Fri 10:00 to 5:00 Fax: (843) 841-3814 (843) 627-3308 PCMH: No Fax: (800) 644-5523 Mon - Thu 8:00 to 5:00 Mon - Fri 10:00 to 5:00 Fri 8:00 to 12:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 158 38642781

Allied Providers Dillon Nurse Practitioner Family Medicine - cont. Sellers, Donna APRN Provider ID: 2094663 Gender: Female Dillon Family Medicine Pa 603 N 6th Ave Dillon, SC 29536-2503 (843) 774-7336 Mon - Fri 8:00 to 5:00 PCMH: No

Physical Therapy Montes, Antonio PT Provider ID: 776970 Gender: Male Dillon Physical Therapy 517 Radford Blvd, Ste A Dillon, SC 29536 (843) 621-0121 Fax: (843) 627-0122 Mon - Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 159 38642781

Allied Providers Florence Audiology Wegmann, Jessica PA Ciancione, Peter CRNA Provider ID: 953343 Provider ID: 1611446 Harris, Lu Etta AUD Gender: Female Gender: Male Provider ID: 777265 Mcleod Cardiology Associates Coastal Healthcare Resources Inc Gender: Female 101 Johns St, Ste 600 1807 W Evans St, Ste C Pee Dee Speech Hearing Center Florence, SC 29506-2779 Florence, SC 29501-3374 153 E N B Baroody St (843) 667-1891 (866) 877-2762 Florence, SC 29506 Fax: (843) 665-2516 Fax: (866) 992-7144 (843) 662-7802 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 662-5601 PCMH: No PCMH: No Mon - Fri 8:30 to 5:00 PCMH: No Certified Nurse Anesthetist Eastep, Alyson CRNA Provider ID: 1962716 Kirby, Lesley AUD Babb, Susan CRNA Gender: Female Provider ID: 1000556 Provider ID: 1603519 Mcleod Regional Medical Center Gender: Female Gender: Female 555 E Cheves St Lifetime Hearing Services Florence Neurosurgery And Spine Florence, SC 29506-2617 522 W Palmetto St PC (843) 777-5240 Florence, SC 29501-4428 1204 E Cheves St Fax: (843) 777-5572 (843) 662-4327 Florence, SC 29506-2710 Mon - Sun 12:00 to 12:00 Fax: (843) 662-4395 (843) 673-0122 PCMH: No Mon - Fri 8:30 to 5:00 Fax: (843) 673-0227 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Jones, Karen CRNA Provider ID: 1832823 Behavioral Health Counseling Gender: Female Bird, Bryan CRNA Mcleod Oncology And Hematology Williamson, Heather LCSW Provider ID: 2211739 401 E Cheves St, Ste 201 Provider ID: 1541211 Gender: Male Florence, SC 29506-2615 Gender: Female Mcleod Regional Medical Center (843) 777-7951 Heather Williamson Lisw Cp 555 E Cheves St Fax: (843) 777-7981 1505 W Palmetto St Florence, SC 29506-2617 Mon - Fri 8:00 to 5:00 Florence, SC 29501-4131 (843) 777-5246 PCMH: No (843) 409-3234 Fax: (843) 777-5572 Fax: (843) 580-8301 Mon - Sun 12:00 to 12:00 Mon - Fri 4:00 to 7:30 PCMH: No Jones, Karen CRNA Sat 9:00 to 4:00 Provider ID: 1832823 PCMH: No Gender: Female Ciancione, Peter CRNA Mcleod Regional Medical Center Provider ID: 1607710 555 E Cheves St Cardiology Gender: Male Florence, SC 29506-2617 Hardee, Joseph PA Florence Neurosurgery And Spine (843) 777-5240 Provider ID: 921408 PC Fax: (843) 777-5572 Gender: Male 1204 E Cheves St Mon - Sun 12:00 to 12:00 Mcleod Cardiology Associates Florence, SC 29506-2710 PCMH: No 101 Johns St, Ste 600 (843) 673-0122 Fax: (843) 673-0227 Florence, SC 29506-2779 Jones, Trisha CRNA (843) 667-1891 Mon - Fri 8:00 to 5:00 PCMH: No Provider ID: 2106358 Fax: (843) 665-2516 Gender: Female Mon - Fri 8:00 to 5:00 Mcleod Regional Medical Center PCMH: No 555 E Cheves St Florence, SC 29506-2617 (843) 777-5246 Fax: (843) 777-5572 Mon - Sun 12:00 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 160 38642781

Allied Providers Florence Certified Nurse Anesthetist - cont. Saylor, Scott CRNA Thomas, Brady CRNA Provider ID: 1607708 Provider ID: 1837375 Matthews, Kimberly CRNA Gender: Male Gender: Male Provider ID: 1607712 Florence Neurosurgery And Spine Mcleod Regional Medical Center Gender: Female PC 555 E Cheves St Florence Neurosurgery And Spine 1204 E Cheves St Florence, SC 29506-2617 1204 E Cheves St Florence, SC 29506-2710 (843) 777-5240 Florence, SC 29506-2710 (843) 673-0122 Fax: (843) 777-5572 (843) 673-0122 Fax: (843) 673-0227 Mon - Sun 12:00 to 12:00 Fax: (843) 673-0227 Mon - Fri 8:00 to 5:00 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Torgersen, Keith CRNA Saylor, Scott CRNA Provider ID: 1607202 Matthews, Kimberly CRNA Provider ID: 1611453 Gender: Male Provider ID: 1611926 Gender: Male Florence Neurosurgery And Spine Gender: Female Coastal Healthcare Resources Inc 1204 E Cheves St Coastal Healthcare Resources Inc 1807 W Evans St, Ste C Florence, SC 29506-2710 1807 W Evans St, Ste C Florence, SC 29501-3374 (843) 673-0122 Florence, SC 29501-3374 (866) 877-2762 Fax: (843) 673-0227 (866) 877-2762 Fax: (866) 992-7144 Mon - Fri 8:00 to 5:00 Fax: (866) 992-7144 Mon - Fri 8:00 to 5:00 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Tyner, Christopher CRNA Smith, Allan CRNA Provider ID: 2313366 Mitchell, Melissa CRNA Provider ID: 2315674 Gender: Male Provider ID: 1607711 Gender: Male Mcleod Regional Medical Center Gender: Female Mcleod Regional Medical Center 555 E Cheves St Florence Neurosurgery And Spine 555 E Cheves St Florence, SC 29506-2617 1204 E Cheves St Florence, SC 29506-2617 (843) 777-5246 Florence, SC 29506-2710 (843) 777-5246 Fax: (843) 777-5572 (843) 673-0122 Fax: (843) 777-5572 Mon - Sun 12:00 to 12:00 Fax: (843) 673-0227 Mon - Sun 12:00 to 12:00 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Villeneuve, Emery CRNA Tanner, Scott CRNA Provider ID: 1607204 Mogy, Catherine CRNA Provider ID: 1602115 Gender: Male Provider ID: 1607180 Gender: Male Florence Neurosurgery And Spine Gender: Female Florence Neurosurgery And Spine 1204 E Cheves St Florence Neurosurgery And Spine 1204 E Cheves St Florence, SC 29506-2710 1204 E Cheves St Florence, SC 29506-2710 (843) 673-0122 Florence, SC 29506-2710 (843) 673-0122 Fax: (843) 673-0227 (843) 673-0122 Fax: (866) 992-7144 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 161 38642781

Allied Providers Florence Clinical Social Work Holt, Monica APRN Blackmon, Tomekia LCSW Provider ID: 1816343 Provider ID: 1420801 Carter, Kaycee CSW Gender: Female Gender: Female Provider ID: 1796888 Eastern Carolina Pediatrics Assoc Precision Behavioral And Medical Gender: Female 1530 Mclure Ct Gr Palmetto Family Works LLC Florence, SC 29505-6174 181 East Evans St, Ste 314 2147 Hoffmeyer Rd (843) 667-6710 Florence, SC 29506 Florence, SC 29501-4015 Fax: (843) 667-4114 (843) 407-5959 (843) 661-6030 Mon - Fri 8:30 to 5:00 Fax: (844) 270-0703 Fax: (843) 679-2633 PCMH: No Mon - Fri 9:00 to 6:00 Mon, Fri 4:30 to 7:30 PCMH: No PCMH: No Sved, Amy APRN Provider ID: 928369 Brady, Melissa CSW Family Practice Gender: Female Provider ID: 2317676 Collins, Diana APRN Musc Physicians Primary Care Gender: Female Provider ID: 1900780 Hoffme Hopehealth Irby Gender: Female 1925 Hoffmeyer Rd 360 N Irby St Musc Physicians Express Care Lake Florence, SC 29501 Florence, SC 29501-2808 C (843) 679-4214 (843) 667-9414 148 Sauls St, Ste E Fax: (843) 679-4217 Fax: (843) 667-1362 Lake City, SC 29560-2677 Musc Health Florence Medical Mon - Sat 8:00 to 8:00 (843) 669-9183 Center PCMH: No Fax: (843) 699-9518 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No Oeffinger, Rebecca CSW PCMH: No Federally Qualified Health Center Provider ID: 2167350 Gender: Female Ferrigno, Michelle APRN Bennett, Meagan ARNP Hopehealth Irby Provider ID: 1254287 Provider ID: 1977571 360 N Irby St Gender: Female Gender: Female Florence, SC 29501-2808 Ferrigno Healthcare Hopehealth Fmu (843) 667-9414 2554 W Palmetto St Subspecialty: HRSA FQHC Fax: (843) 667-1362 Florence, SC 29501 121 S Evander Dr Mon - Sat 8:00 to 8:00 (843) 662-2110 Florence, SC 29506-4212 PCMH: No Fax: (855) 650-3714 (843) 661-1848 Mon - Fri 9:00 to 5:00 Fax: (843) 661-1818 PCMH: No Mon - Tue, Thu - Fri 8:30 to 5:00 Sanders, Lecole LCSW PCMH: No Provider ID: 1162283 Gender: Female Hill, James APRN Sanders Family Counseling LLC Provider ID: 1190175 Licensed Clinical Social Worker Gender: Male 1803 Cherokee Rd Pee Dee Cardiology Associates Black, Sharon CSW Florence, SC 29501 101 William H Johnson St, Ste 600 Provider ID: 2315704 (843) 661-6030 Florence, SC 29506 Gender: Female Fax: (843) 679-2633 (843) 667-1891 Hopehealth Irby Mon 2:00 to 6:30 Fax: (843) 665-2516 360 N Irby St Tue, Thu 9:00 to 6:00 Mon - Fri 8:00 to 5:00 Florence, SC 29501-2808 Wed 10:30 to 6:30 PCMH: No (843) 667-9414 Sat 9:00 to 3:00 Fax: (843) 667-1362 PCMH: No Mon - Sat 8:00 to 8:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 162 38642781

Allied Providers Florence Licensed Clinical Social Worker - Licensed Professional Counselor Daniels, Prezillic LPC cont. Provider ID: 912444 Bakas, Efstasia LPC Gender: Female Smalls, Chatonia CSW Provider ID: 1441385 Daniels Discovery Dynamics Provider ID: 2317842 Gender: Female 1803 Cherokee Rd Gender: Female Stewart Behavioral Health Florence, SC 29501-4184 Hopehealth Inc 525 S Dargan St (843) 661-6030 600 E Palmetto St Florence, SC 29506 Fax: (843) 679-2633 Florence, SC 29506-2851 (843) 407-5419 Mon, Wed 2:00 to 6:00 (843) 667-9414 Fax: (843) 407-7274 Fri 9:00 to 5:00 Fax: (843) 667-1362 Mon - Thu 9:00 to 7:00 PCMH: No Mon - Fri 7:30 to 5:00 Fri 3:00 to 7:00 PCMH: No PCMH: No Dennis, Brandi LPC Provider ID: 2104363 Wilson, Toni Marie CSW Carter, Krystal LPC Gender: Female Provider ID: 1857104 Provider ID: 1107682 Carolina Pediatric Counseling Gender: Female Gender: Female 2011 2nd Loop Rd, Ste A Hopehealth Irby 181 E Evans St, Ste 316 Florence, SC 29501-6187 360 N Irby St Florence, SC 29506-5505 (843) 468-1850 Florence, SC 29501-2808 (843) 605-5228 Fax: (843) 407-4265 (843) 667-9414 Fax: (803) 474-8342 Mon - Sat 8:00 to 6:00 Fax: (843) 667-1362 PCMH: No PCMH: No Mon - Sat 8:00 to 8:00 PCMH: No Casley, Denise LPC Durant, Kelvin LPC Provider ID: 1050614 Provider ID: 1439020 Licensed Independent Social Worker Gender: Female Gender: Male Denise F Casley Lpc Stewart Behavioral Health Peterkin, Vicky LCSW 1358 S Irby St, Ste C 525 S Dargan St Provider ID: 1558413 Florence, SC 29501-2636 Florence, SC 29506 Gender: Female (843) 610-8674 (843) 407-5419 Sanders Family Counseling LLC Fax: (846) 679-5550 Fax: (843) 407-7274 1803 Cherokee Rd Mon - Fri 9:00 to 5:00 Mon - Fri 9:00 to 6:00 Florence, SC 29501 PCMH: No PCMH: No (843) 661-6030 Fax: (843) 679-2633 Daniels, Prezillic LPC Elkins, Jennifer LPC Mon - Fri 8:00 to 5:00 Provider ID: 1605092 PCMH: No Provider ID: 1342173 Gender: Female Gender: Female Care House Of The Pee Dee Palmetto Family Works LLC Licensed Mental Health Counselor 360 N Irby St 1803 Cherokee Rd Florence, SC 29501 Malvarosa, Paul LPC Florence, SC 29501 (843) 629-0236 (843) 661-6030 Provider ID: 1522089 Fax: (843) 673-9223 Gender: Male Fax: (843) 679-2633 Mon - Fri 8:00 to 5:00 Mon - Tue 9:00 to 7:00 Wellspring Psychology Group LLC PCMH: No 1340 Celebration Blvd, Unit A Wed 9:00 to 8:00 Florence, SC 29501-5585 Thu - Fri 9:00 to 5:30 (843) 536-1180 Sat 9:00 to 3:00 Fax: (843) 536-1116 PCMH: No Mon 9:00 to 7:00 Tue - Thu 8:00 to 7:00 Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 163 38642781

Allied Providers Florence Licensed Professional Counselor - Goodwin, Misty LPC Jefferson, Samantha LPC cont. Provider ID: 1025668 Provider ID: 1853452 Gender: Female Gender: Female Fulcher, Rosanne LPC Carolina Pediatric Counseling Hopehealth Irby Provider ID: 1074082 2011 2nd Loop Rd, Ste A 360 N Irby St Gender: Female Florence, SC 29501-6187 Florence, SC 29501-2808 Wellspring Psychology Group (843) 468-1850 (843) 667-9414 1340 Celebration Blvd, Unit A Fax: (843) 407-4265 Mon - Sat 8:00 to 8:00 Florence, SC 29501-5585 Mon 9:00 to 4:00 PCMH: No (843) 536-1180 Wed, Fri 10:00 to 4:00 Fax: (843) 536-1116 PCMH: No Kahn, David LCSW Mon - Thu 8:00 to 7:00 Provider ID: 837561 Fri 8:00 to 5:00 Graham, Carrie LPC Gender: Male PCMH: No Provider ID: 1557309 The Counseling Center Of Florence Gender: Female 616 S Coit St Fuller, Clara LPC Cw Counseling Consulting Group Florence, SC 29501-5223 Provider ID: 908928 LLC (843) 673-0054 Gender: Female 1800 2nd Loop Rd, Ste 3 Fax: (843) 667-1549 Fuller Life Strategies LLC Florence, SC 29501-6180 Mon - Thu 7:30 to 8:00 1803 Cherokee Rd (843) 667-1905 PCMH: No Florence, SC 29501-4184 Mon - Wed 8:30 to 6:00 (843) 661-6030 Thu - Fri 8:30 to 4:00 Knight, Aimee LPC Fax: (843) 679-2633 PCMH: No Provider ID: 1523826 Mon, Wed 8:30 to 8:00 Gender: Female Tue, Thu 8:30 to 5:00 Graham, Elizabeth LPC Solid Rock Family Counseling Servic Sat 8:30 to 3:00 Provider ID: 2378512 181 E Evans St Btc-122, Ste 316 PCMH: No Gender: Female Florence, SC 29506 Florence Counseling Solutions (843) 617-4676 Gamble, Natalie LPC 2147 Hoffmeyer Rd Mon - Fri 9:00 to 7:00 Provider ID: 1714266 Florence, SC 29501-4015 Sat 9:00 to 12:00 Gender: Female (843) 773-3061 PCMH: No Hopehealth Inc Mon - Thu 9:00 to 7:00 600 E Palmetto St Fri 9:00 to 3:00 Langley, Laura LPC Florence, SC 29506-2851 PCMH: No Provider ID: 818271 (843) 667-9414 Gender: Female Fax: (843) 667-1362 Graham, Elizabeth LPC The Counseling Center Of Florence Mon - Fri 7:30 to 5:00 Provider ID: 2391739 616 S Coit St PCMH: No Gender: Female Florence, SC 29501-5223 Palmetto Family Works LLC (843) 673-0054 Gonzales Acevado, Camille LPC 2147 Hoffmeyer Rd Fax: (843) 667-1549 Provider ID: 1591724 Florence, SC 29501-4015 Mon - Thu 7:30 to 8:00 Gender: Female (843) 773-3061 PCMH: No Wellspring Psychology Group LLC Mon - Thu 9:00 to 7:00 1340 Celebration Blvd Fri 9:00 to 3:00 Florence, SC 29501 PCMH: No (843) 536-1180 Fax: (843) 536-1116 Mon 9:00 to 7:00 Tue - Thu 8:00 to 7:00 Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 164 38642781

Allied Providers Florence Licensed Professional Counselor - Mazgaj, Jamie LPC Mcknight, Deloris LPC cont. Provider ID: 966686 Provider ID: 1049910 Gender: Female Gender: Female Lobo, Vanessa LPC Jamie Mazgaj Positive Solutions Counseli Ng Serv Provider ID: 1792799 1801 W Evans St, Ste 105 181 E Evans St Gender: Female Florence, SC 29501-3376 Florence, SC 29506-5503 Wellspring Psychology Group LLC (843) 661-1010 (843) 676-9400 1340 Celebration Blvd Fax: (877) 333-0211 Fax: (843) 664-2803 Florence, SC 29501-5585 Mon - Fri 4:00 to 8:00 Mon - Fri 9:00 to 5:00 (843) 536-1180 PCMH: No PCMH: No Fax: (843) 536-1116 Mon 9:00 to 7:00 Mcclam, Andrea LPC Muldrow, Javonnia LPC Tue - Thu 8:00 to 7:00 Provider ID: 1185330 Provider ID: 1420298 Fri 8:00 to 5:00 Gender: Female Gender: Female PCMH: No Higher Ground Christian Counseling Precision Behavioral And Medical 221 Big Swamp Rd Gr Lownsberry, Erick LPC Pamplico, SC 29583 181 East Evans St, Ste 314 Provider ID: 2176651 (843) 687-8754 Florence, SC 29506 Gender: Male Fax: (843) 799-1367 (843) 407-5959 The Counseling Center Of Florence Tue, Thu - Fri 8:00 to 6:00 Fax: (844) 270-0703 616 S Coit St Wed 12:00 to 5:00 Mon - Fri 9:00 to 6:00 Florence, SC 29501 PCMH: No Sat AP:PT to ON:LY (843) 673-0054 PCMH: No Fax: (843) 667-1549 Mcdaniel, Anita LPC Mon - Thu 7:30 to 7:30 Provider ID: 1202009 Munson Matthew, Megan LPC PCMH: No Gender: Female Wellspring Psychology Group Provider ID: 1326349 Macaluso, Sherry LPC 1340 Celebration Blvd, Unit A Gender: Female Provider ID: 1963255 Florence, SC 29501 Care House Of The Pee Dee Gender: Female (843) 536-1180 360 N Irby St Carolina Pediatric Counseling Fax: (843) 536-1116 Florence, SC 29501 2011 2nd Loop Rd, Ste A Mon 9:00 to 7:00 (843) 629-0236 Florence, SC 29501-6187 Tue - Thu 8:00 to 7:00 Fax: (843) 973-6223 (843) 468-1850 Fri 8:00 to 5:00 Mon - Fri 8:30 to 5:00 Fax: (843) 407-4265 PCMH: No PCMH: No Mon - Sat 8:30 to 6:00 PCMH: No Mcdaniel, Anita LPC Nance, Clyde LPC Provider ID: 2165298 Provider ID: 2261245 Martin, John LPC Gender: Female Gender: Male Provider ID: 1242528 Cast Counseling LLC Counseling Center Of Florence LLC Gender: Male 2137 Hoffmeyer Rd, Ste E 616 S Coit St J G Enterprises LLC Florence, SC 29501-4088 Florence, SC 29501-5223 616 S Coit St (843) 306-2275 (843) 673-0054 Florence, SC 29501 Fax: (843) 627-2440 Fax: (843) 667-1549 (843) 673-0054 Mon - Fri 8:00 to 5:00 Mon - Thu 7:30 to 7:30 Fax: (843) 667-1549 PCMH: No PCMH: No Mon - Thu 7:30 to 8:30 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 165 38642781

Allied Providers Florence Licensed Professional Counselor - Rush, Amy LPC Temple, Megan LPC cont. Provider ID: 1518793 Provider ID: 1326350 Gender: Female Gender: Female Oquinn, Georgann LPC Palmetto Family Works Care House Of The Pee Dee Provider ID: 913563 1803 Cherokee Rd 360 N Irby St Gender: Female Florence, SC 29501 Florence, SC 29501 Hopehealth (843) 661-6030 (843) 629-0236 600 E Palmetto St Fax: (843) 679-2633 Fax: (843) 673-9223 Florence, SC 29506-2851 Mon - Thu 8:00 to 8:00 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No Townsend, Anna LPC Oquinn, Georgann LPC Simon-Mcqueen, Ryedenna LMHC Provider ID: 1519481 Provider ID: 913563 Gender: Female Gender: Female Provider ID: 1022391 Fuller Life Strategies LLC 360 N Irby St Gender: Female 1803 Cherokee Rd Florence, SC 29501-2808 Simon Counseling And Consultin Florence, SC 29501 (843) 667-9414 1803 Cherokee Rd (843) 661-6030 Fax: (843) 667-1362 Florence, SC 29501-4184 Mon - Fri 8:00 to 8:00 Mon - Fri 8:00 to 5:00 (843) 661-6030 Sat 8:00 to 1:00 PCMH: No Fax: (843) 679-2633 PCMH: No Tue 8:00 to 8:30 Rintelman, Michael LPC Fri 7:30 to 6:30 Townsend, Anna LPC Provider ID: 1567365 Sat 8:30 to 12:00 Provider ID: 1523422 Gender: Male PCMH: No Gender: Female Wellspring Psychology Group LLC Palmetto Family Works LLC 1340 Celebration Blvd, Unit A Stewart, Martha LPC 1803 Cherokee Rd Florence, SC 29501 Provider ID: 1607709 Florence, SC 29501-4184 (843) 536-1180 Gender: Female (843) 661-6030 Fax: (843) 536-1116 Higher Ground Christian Counseling Fax: (843) 679-2633 Mon 9:00 to 7:00 2143 Hoffmeyer Rd, Ste B Mon - Fri 9:00 to 5:00 Tue - Thu 8:00 to 7:00 Florence, SC 29501-4078 PCMH: No Fri 8:00 to 5:00 (843) 687-8754 PCMH: No Fax: (843) 799-1367 Tyner, Faith LPC Mon - Fri 9:00 to 5:00 Provider ID: 1188309 Rogers, Mary LPC PCMH: No Gender: Female Provider ID: 1165268 Wellspring Psychology Group Gender: Female Stewart, Martha LPC 1340 Celebration Blvd, Unit A Wellspring Psychology Group Provider ID: 952975 Florence, SC 29501 1340 Celebration Blvd Gender: Female (843) 536-1180 Florence, SC 29501 Stewart Behavioral Health Fax: (843) 536-1116 (843) 536-1180 525 S Dargan St Mon - Tue, Fri 8:00 to 5:00 Fax: (843) 536-1116 Florence, SC 29506-2549 Wed 8:00 to 7:00 Mon 9:00 to 7:00 (843) 407-5419 PCMH: No Tue - Thu 8:00 to 7:00 Fax: (843) 407-7274 Fri 8:00 to 5:00 Mon - Thu 8:00 to 7:00 PCMH: No Fri 8:00 to 5:00 Sat 10:00 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 166 38642781

Allied Providers Florence Licensed Professional Counselor - Whitman, Gretchen LPC Licensed Social Worker cont. Provider ID: 2104444 Gender: Female Wright, Carol LSW Tyner, Faith LPC Carolina Pediatric Counseling Provider ID: 1074289 Provider ID: 1188309 2011 2nd Loop Rd, Ste A Gender: Female Gender: Female Florence, SC 29501-6187 Cw Counseling Consulting Group Wellspring Psychology Group (843) 468-1850 LLC 1340 Celebration Blvd, Unit C Fax: (843) 407-4265 1800 2nd Loop Rd, Ste 3 Florence, SC 29501 Mon, Wed - Sat 8:00 to 6:00 Florence, SC 29501-6180 (843) 536-1180 Tue 8:00 to 8:00 (843) 667-1905 Fax: (843) 536-1116 PCMH: No Mon - Wed 8:30 to 6:00 Mon - Tue, Fri 8:00 to 5:00 Thu 8:30 to 4:00 Wed 8:00 to 7:00 Fri 8:30 to 4:0 Wilcox, Scott LPC PCMH: No PCMH: No Provider ID: 1428135 Gender: Male Underwood, Timothy LPC Sanders Family Counseling LLC Wright, Carol LSW Provider ID: 1021934 2147 Hoffmeyer Rd Provider ID: 1074289 Gender: Male Florence, SC 29501 Gender: Female Timothy Underwood (843) 661-6030 Cw Counseling And Consulting LLC 3750 Sheminally Rd Fax: (843) 679-2633 123 Kelly St Pamplico, SC 29583-5700 PCMH: No Kingstree, SC 29560-3428 (843) 488-1894 (843) 667-1905 Fax: (843) 667-1723 Fax: (843) 491-4023 Wilcox, Scott LPC Mon - Fri 8:00 to 5:00 Wed 9:00 to 6:30 Provider ID: 1523383 PCMH: No PCMH: No Gender: Male 2147 Hoffmeyer Rd Wallace, Donya LPC Florence, SC 29501 Nurse Practitioner (843) 661-6030 Provider ID: 773971 Banner, Meredith CNP Gender: Female Fax: (843) 661-6030 PCMH: No Provider ID: 770349 Wallace Donya D Gender: Female 263 Kelley St Mcleod Orthopaedics Florence Lake City, SC 29560 Williams, Misty LPC 1005 E Cheves St (843) 394-8274 Provider ID: 1801196 Florence, SC 29506-2707 Fax: (843) 394-1604 Gender: Female (843) 662-5233 Mon, Wed 9:00 to 6:00 Palmetto Family Works LLC Fax: (843) 432-1930 Tue, Thu - Fri 9:00 to 5:00 2147 Hoffmeyer Rd Mon - Fri 8:00 to 5:00 PCMH: No Florence, SC 29501-4015 PCMH: No (843) 661-6030 Fax: (843) 661-6030 Wells, Terrance LPC Bennett, Meagan ARNP Provider ID: 1255191 Mon - Fri 8:00 to 8:00 PCMH: No Provider ID: 1977571 Gender: Male Gender: Female Family Support Services LLC Hopehealth Fmu 652 N Matthews Rd Subspecialty: HRSA FQHC Lake City, SC 29560 121 S Evander Dr (803) 744-6171 Florence, SC 29506-4212 Fax: (877) 590-0231 (843) 661-1848 Mon - Fri 9:00 to 5:00 Fax: (843) 661-1818 PCMH: No Mon - Tue, Thu - Fri 8:30 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 167 38642781

Allied Providers Florence Nurse Practitioner - cont. Felder, Melissa APRN Harrell, Ashley APRN Provider ID: 1818791 Provider ID: 1432737 Bryant, Stacie ARNP Gender: Female Gender: Female Provider ID: 1899288 Hopehealth Inc Mcleod Digestive Health Center Gender: Female 600 E Palmetto St 401 E Cheves St, Ste 301 Healogics Specialty Physicians Of S Florence, SC 29506-2851 Florence, SC 29506-2615 1580 Freedom Blvd, Ste 106 (843) 667-9414 (843) 777-7166 Florence, SC 29505-6074 Fax: (843) 667-1362 Fax: (843) 777-7167 (843) 674-4570 Mon - Fri 7:30 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (904) 446-3032 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Fisher, Sierra APRN Mcfadden, Sherrlyn APRN Provider ID: 1736990 Provider ID: 1246652 Chinich, Caren CNP Gender: Female Gender: Female Provider ID: 1360832 Mcleod Cardiology Associates Genesis Healthcare Inc. DBA Olanta Gender: Female 101 Johns St, Ste 600 211 S Jones Rd Mcleod Regional Medical Center Florence, SC 29506 Olanta, SC 29114-9705 555 E Cheves St (843) 667-1891 (843) 396-9730 Florence, SC 29506-2617 Mon - Fri 8:00 to 5:00 Fax: (843) 396-9735 (843) 777-5753 PCMH: No Mon - Thu 8:00 to 5:00 Fax: (843) 777-5035 Fri 8:00 to 12:00 Mon - Sun 12:00 to 12:00 PCMH: No PCMH: No Garris, Theressa ARNP Provider ID: 766863 Gender: Female Miller, Michelle APRN Coleman, Megan APRN Pediatric Associates Of Florence Provider ID: 1959792 Provider ID: 2200685 204 E Cheves St Gender: Female Gender: Female Florence, SC 29506 Mcleod Urology Associates Mcleod Cardiology Assoc (843) 777-5765 800 E Cheves St, Ste 350 101 William H Johnson St, Ste 600 Fax: (843) 662-2474 Florence, SC 29506-2649 Florence, SC 29506-2773 Mon, Wed - Thu 8:00 to 3:30 (843) 777-7555 (843) 667-1891 Tue, Fri 9:00 to 5:00 Fax: (843) 777-7563 Fax: (843) 665-2516 PCMH: No Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Gude, Adam CNP Provider ID: 1360833 Polsky, Roger APRN Elder, Sherry APRN Gender: Male Provider ID: 1211991 Provider ID: 1257007 Mcleod Regional Medical Center Gender: Male Gender: Female 555 E Cheves St Musc Physicians Gastroenterology Sc House Calls Inc Florence, SC 29506-2617 Fl 3006 Hoffmeyer Rd (843) 777-2000 805 Pamplico Hwy, Ste A-220 Florence, SC 29501-7551 Fax: (843) 777-5035 Florence, SC 29505 (843) 292-0012 Mon - Sun 12:00 to 12:00 (843) 674-1530 Mon - Fri 9:00 to 5:00 PCMH: No Fax: (843) 673-9098 PCMH: No Musc Health Florence Medical Hamer, Melissa APRN Center Provider ID: 1836601 Mon - Fri 8:00 to 5:00 Gender: Female PCMH: No Mcleod Regional Medical Center 555 E Cheves St Florence, SC 29506-2617 (843) 777-5240 Fax: (843) 777-5572 Mon - Sun 12:00 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 168 38642781

Allied Providers Florence Nurse Practitioner - cont. Wicker, Maryum APRN Brown, Angel APRN Provider ID: 2047257 Provider ID: 2068674 Pritchard, Pamela APRN Gender: Female Gender: Female Provider ID: 1838420 Mcleod Urgent Care Center Mcleod Urgent Care Center Gender: Female 3015 W Palmetto St 3015 W Palmetto St Mcleod Regional Medical Center Florence, SC 29501-5935 Florence, SC 29501-5935 555 E Cheves St (843) 777-6890 (843) 777-6890 Florence, SC 29506-2617 Fax: (843) 777-6871 Fax: (843) 777-6871 (843) 777-5240 Mon - Fri 8:00 to 8:00 Mon - Fri 8:00 to 8:00 Fax: (843) 777-5572 Sat - Sun 9:00 to 8:00 Sat - Sun 9:00 to 4:00 Mon - Sun 12:00 to 12:00 PCMH: No PCMH: No PCMH: No Woodberry, Elizabeth APRN Curl, Anita APRN Rogers, Katelyn APRN Provider ID: 2196410 Provider ID: 2201356 Provider ID: 959240 Gender: Female Gender: Female Gender: Female Mcleod Primary Care Partners Mcleod Regional Medical Center Mpa Pediatric Endocrinology 800 E Cheves St, Ste 240 555 E Cheves St 101 Johns St, Ste 400 Florence, SC 29506-2651 Florence, SC 29506-2617 Florence, SC 29506-2635 (843) 777-9450 (843) 777-5246 (843) 777-7300 Fax: (843) 678-3624 Fax: (843) 777-5572 Fax: (843) 777-7320 Mon - Fri 8:00 to 5:00 Mon - Sun 12:00 to 12:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No Fulwood, Karen APRN Russ, Brandi ARNP Nurse Practitioner Acute Care Provider ID: 1271382 Provider ID: 2237579 Gender: Female Gender: Female Robinson, Tricia APRN Olanta Family Care Mcleod Family Practice Timmons- Provider ID: 1574015 211 S Jones Rd ville Gender: Female Olanta, SC 29114-9705 755 E Smith St Musc Physicians Urology Florence (843) 396-9730 Timmonsville, SC 29161-9430 Me Fax: (843) 396-9735 (843) 346-3900 805 Pamplico Hwy, Ste B310 Mon - Fri 8:00 to 5:00 Fax: (843) 346-7839 Florence, SC 29505-6068 Sat 8:00 to 12:00 Mon - Fri 8:00 to 5:00 (843) 673-7525 PCMH: No PCMH: No Fax: (843) 673-7528 Musc Health Florence Medical Center Gainey, Cynthia APRN Stephen, Natasha CNP Mon - Fri 8:00 to 5:00 Provider ID: 2015693 Provider ID: 1360835 PCMH: No Gender: Female Gender: Female Doctors Care Hoffmeyer Road Mcleod Regional Medical Center 2410 Hoffmeyer Rd 555 E Cheves St Nurse Practitioner Family Medicine Florence, SC 29501-7311 Florence, SC 29506-2617 Bass, Morgan APRN (843) 662-8182 (843) 777-3717 Fax: (843) 662-8183 Fax: (843) 777-5035 Provider ID: 2402359 Gender: Female Mon - Fri 8:00 to 8:00 Mon - Sun 12:00 to 12:00 Sat - Sun 9:00 to 5:00 PCMH: No Genesis Healthcare Inc DBA Olanta F PCMH: No 211 S Jones Rd Olanta, SC 29114-9705 (843) 396-9730 Fax: (843) 396-9735 Mon - Thu 8:00 to 5:00 Fri 8:00 to 12:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 169 38642781

Allied Providers Florence Nurse Practitioner Family Medicine - Hewitt, Carolina APRN Mcdougal, Patrick ARNP cont. Provider ID: 2138068 Provider ID: 2176183 Gender: Female Gender: Male Godwin, Ashton APRN Mcleod Pulmonary & Critical Care Pee Dee Surgical Group Provider ID: 2276080 As 800 E Cheves St, Ste 260 Gender: Female 401 E Cheves St, Ste 202 Florence, SC 29506-2652 Mcleod Urology Associates Florence, SC 29506-2615 (843) 665-7941 800 E Cheves St, Ste 350 (843) 777-7863 Fax: (843) 665-1257 Florence, SC 29506-2649 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 (843) 777-7555 PCMH: No PCMH: No Fax: (843) 777-7563 Mon - Fri 8:00 to 5:00 Johnson, Denise APRN Osorio, Jolene APRN PCMH: No Provider ID: 2155961 Provider ID: 1273480 Gender: Female Gender: Female Godwin, Ashton APRN Mcleod Cardiology Assoc Olanta Family Care Provider ID: 2276080 101 William H Johnson St, Ste 600 211 S Jones Rd Gender: Female Florence, SC 29506-2773 Olanta, SC 29114-9705 Pee Dee Surgical Group (843) 667-1891 (843) 396-9730 800 E Cheves St, Ste 260 Fax: (843) 665-2516 Fax: (843) 396-9735 Florence, SC 29506-2652 Mon - Fri 8:00 to 5:00 Mon - Thu 8:00 to 5:00 (843) 665-7941 PCMH: No Fri 8:00 to 12:00 Fax: (843) 665-1257 PCMH: No Mon - Fri 8:00 to 5:00 Kirven, Lauren APRN PCMH: No Provider ID: 2180773 Peters, Jon APRN Gender: Female Provider ID: 1445495 Graham, Almeda APRN Mcleod Cardiology Associates Gender: Male Provider ID: 1870553 101 William H Johnson St, Ste 600 Musc Physicians Express Care Gender: Female Florence, SC 29506-2773 Floren Healthy Living Wellness And (843) 667-1891 148 Sauls St, Ste C Healthc Fax: (843) 665-2516 Lake City, SC 29560-2677 105 S Franklin Dr Mon - Fri 8:00 to 5:00 (843) 699-9183 Florence, SC 29501-4364 PCMH: No Fax: (843) 699-9518 (843) 475-2523 Musc Health Florence Medical Fax: (843) 492-7418 Lawrimore, Cynthia APRN Center Mon - Thu 8:00 to 5:00 Provider ID: 1297708 Mon - Fri 2:00 to 10:00 Fri 8:00 to 12:00 Gender: Female Sat 9:00 to 6:00 PCMH: No Musc Physicians Primary Care PCMH: No Pampli Hardee, Chelsea APRN 953 S Pamplico Hwy Peters, Jon APRN Provider ID: 2176177 Pamplico, SC 29583 Provider ID: 1445495 Gender: Female (843) 493-5252 Gender: Male Pee Dee Surgical Group Fax: (843) 493-2372 Musc Physicians Express Care 800 E Cheves St, Ste 260 Musc Health Florence Medical Floren Florence, SC 29506-2652 Center 1925 Hoffmeyer Rd (843) 665-7941 Mon, Wed - Thu 8:00 to 5:00 Florence, SC 29501 Fax: (843) 665-1257 Tue 8:00 to 7:00 (843) 413-6925 Mon - Fri 8:00 to 5:00 Fri 8:00 to 12:00 Musc Health Florence Medical PCMH: No PCMH: No Center Mon - Fri 2:00 to 10:00 Sat 9:00 to 6:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 170 38642781

Allied Providers Florence Nurse Practitioner Family Medicine - Smith, Morgan APRN Weaver, Timothy APRN cont. Provider ID: 2141439 Gender: Female Provider ID: 1856318 Ralley, Tasha APRN Doctors Care South Irby Gender: Male Provider ID: 1594255 2200 S Irby St Hopehealth Irby Gender: Female Florence, SC 29505 360 N Irby St Mcleod Cardiothoracic Surgical (843) 662-9945 Florence, SC 29501-2808 Asso Fax: (843) 662-9946 (843) 667-9414 101 S Ravenel St, Ste 270 Mon - Fri 8:00 to 8:00 Fax: (843) 667-1362 Florence, SC 29506 PCMH: No Mon - Sat 8:00 to 8:00 (843) 777-7020 PCMH: No Fax: (843) 664-9545 Timmons, Lindsey APRN Mon - Fri 8:30 to 5:00 Provider ID: 2180740 Wiggins, Christi APRN PCMH: No Gender: Female Provider ID: 1829393 Pee Dee Surgical Group Gender: Female Saxon, Angela APRN 800 E Cheves St, Ste 260 Mcleod Cardiology Associates Provider ID: 1502233 Florence, SC 29506-2652 101 William H Johnson St, Ste 600 Gender: Female (843) 665-7941 Florence, SC 29506-2773 Mcleod Family Medicine Johnson- Fax: (843) 665-1257 (843) 667-1891 ville Mon - Fri 8:00 to 5:00 Fax: (843) 665-2516 355 S Georgetown Hwy PCMH: No Mon - Fri 8:00 to 5:00 Johnsonville, SC 29555-8083 PCMH: No (843) 380-2000 Wallace, Lisa APRN Fax: (843) 380-2014 Provider ID: 1560685 Nurse Practitioner Gerentology Mon - Thu 8:00 to 5:00 Gender: Female Fri 8:00 to 12:00 Mcleod Family Medicine Health Fitn Kasitz, Jesse APRN PCMH: No 2437 Willwood Dr Provider ID: 2138175 Florence, SC 29501-3904 Gender: Male Slice, Allison CNP (843) 777-3100 Pee Dee Surgical Group Provider ID: 775955 Fax: (843) 777-3111 800 E Cheves St, Ste 260 Gender: Female Mon - Thu 8:00 to 5:00 Florence, SC 29506-2652 Jeter Skinner Family Practice Fri 8:00 to 12:00 (843) 665-7941 101 S Ravenel St, Ste 160 PCMH: No Fax: (843) 665-1257 Florence, SC 29506-2622 Mon - Fri 8:00 to 5:00 PCMH: No (843) 662-1533 Wallace, Lisa APRN Fax: (843) 679-7273 Provider ID: 2196430 Mon - Fri 9:00 to 5:00 Gender: Female Kight, Paige APRN PCMH: No Mcleod Primary Care Partners Provider ID: 1784744 800 East Cheves Street, Suite 240 Gender: Female Smith, Machelle APRN Florence, SC 29506-2652 Carolinas Medical Allicance Inc Provider ID: 1577722 (843) 777-9450 148 Sauls St, Ste E Gender: Female Fax: (843) 678-3624 Lake City, SC 29560-2677 Mcleod Urology Associates PCMH: No (843) 699-9183 800 E Cheves St, Ste 350 Fax: (843) 699-9516 Florence, SC 29506-2649 Musc Health Florence Medical (843) 665-2000 Center Fax: (843) 669-1701 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 171 38642781

Allied Providers Florence Nurse Practitioner Gerentology - Owens, Kimberly APRN Occupational Therapy cont. Provider ID: 1362207 Gender: Female Belk, Cindy OT Kight, Paige APRN Musc Physicians Pee Dee Primary Provider ID: 1328029 Provider ID: 1784744 Car Gender: Female Gender: Female 1594 Freedom Blvd, Ste C202 Mcleod Orthopaedics Florence Carolinas Medical Allicance Inc Florence, SC 29505 1005 E Cheves St 1925 Hoffmeyer Rd (843) 664-9696 Florence, SC Florence, SC 29501-4011 Fax: (843) 629-7209 (843) 662-5233 (843) 679-4214 Musc Health Florence Medical Fax: (843) 678-9003 Fax: (843) 679-4217 Center Mon 8:00 to 4:30 Musc Health Florence Medical Mon - Fri 8:00 to 5:00 Tue 8:00 to 5:30 Center PCMH: No Wed - Thu 8:00 to 5:00 Mon - Fri 2:00 to 10:00 Fri 8:00 to 1:00 PCMH: No Sat 9:00 to 6:00 Nurse Practitioner Womens Health PCMH: No Parker, Melinda APRN Blackwell, Joyce OT Kight, Paige APRN Provider ID: 1557340 Provider ID: 776116 Provider ID: 1784744 Gender: Female Gender: Female Gender: Female Ohio Valley Physicians Inc Mcleod Regional Medical Center Musc Physicians Primary Care 238 S Coit St 440 2nd Loop Rd Vance Florence, SC 29501-4422 Florence, SC 29501 2501 S Vance Dr, Ste A (843) 665-9349 (843) 777-4075 Florence, SC 29505-6163 Fax: (843) 667-1615 Mon - Fri 9:00 to 5:00 (843) 679-4019 Mon - Fri 8:30 to 4:30 PCMH: No Fax: (843) 679-4022 PCMH: No Musc Health Florence Medical Blasius, Melony MD Center Nutrition Provider ID: 776127 Mon - Thu 8:00 to 5:00 Gender: Male Fri 8:00 to 1:00 Finklea, Kitty RD Mcleod Regional Medical Center PCMH: No Provider ID: 951674 555 E Cheves St Gender: Female Florence, SC 29506-2617 Owens, Kimberly APRN Hopehealth Irby (843) 777-2000 Provider ID: 1362207 360 N Irby St Mon - Fri 9:00 to 5:00 Florence, SC 29501-2808 PCMH: No Gender: Female (843) 667-9414 148 Sauls St, Ste E Fax: (843) 667-1362 Lake City, SC 29560-2677 Mon - Sat 8:00 to 8:00 Einziger, Samantha OT (843) 699-9183 PCMH: No Provider ID: 1768055 Fax: (843) 699-9518 Gender: Female Musc Health Florence Medical Mcleod Orthopaedics Florence Center Longan, Anita RD 1005 E Cheves St PCMH: No Provider ID: 934369 Florence, SC 29506-2707 Gender: Female (843) 777-7900 360 N Irby St Fax: (843) 777-7925 Florence, SC 29501-2808 Mon - Thu 8:00 to 5:00 (843) 432-3714 Fri 8:00 to 1:00 Fax: (843) 656-8865 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 172 38642781

Allied Providers Florence Occupational Therapy - cont. Huiet, Christopher PA Belser Jr, Roy PT Provider ID: 1278403 Provider ID: 1486761 Feagin, Brian OT Gender: Male Gender: Male Provider ID: 772922 Mcleod Orthopaedics Florence Pro-Motion Physical Therapy Gender: Male 1005 E Cheves St 610 W Palmetto St Mcleod Orthopaedics Florence Florence, SC 29506-2707 Florence, SC 29501 1005 E Cheves St (843) 662-5233 (843) 407-0377 Florence, SC 29506-2707 Fax: (843) 432-1930 Fax: (843) 799-1944 (843) 662-5233 Mon - Fri 8:00 to 5:00 Mon - Thu 8:00 to 5:00 Fax: (843) 432-1930 PCMH: No Fri 8:00 to 12:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Ulmer, John PA Provider ID: 949624 Bunten, Kimberly PT Orthopaedic Surgery Gender: Male Provider ID: 1432392 Alford, Bryan PA Mcleod Orthopaedics Gender: Female Provider ID: 1046700 800 E Cheves St, Ste 480 Priority Physical Therapy Gender: Male Florence, SC 29506-2653 2521 S Cashua Dr Mcleod Orthopaedics Florence (843) 777-7900 Florence, SC 29501 1005 E Cheves St Fax: (843) 777-7925 (843) 536-4888 Florence, SC 29506-2707 Mon - Fri 8:00 to 5:00 Fax: (843) 799-0992 (843) 777-7900 PCMH: No Mon - Fri 7:00 to 5:30 Fax: (843) 777-7925 PCMH: No Mon - Fri 8:00 to 5:00 Ulmer, John PA PCMH: No Provider ID: 949624 Bushman, Michael PT Gender: Male Provider ID: 2167105 Crisp, Brian PA Mcleod Orthopaedics Florence Gender: Male Provider ID: 953681 1005 E Cheves St Priority Physical Therapy Gender: Male Florence, SC 29506-2707 148 Sauls St, Ste B Mcleod Orthopaedics (843) 777-7900 Lake City, SC 29560-2677 800 E Cheves St, Ste 480 Fax: (843) 777-7925 (843) 536-4888 Florence, SC 29506-2653 Mon - Fri 8:00 to 5:00 Fax: (843) 799-0992 (843) 777-7900 PCMH: No Mon - Thu 8:00 to 6:00 Fax: (843) 777-7925 Fri 8:00 to 12:00 Mon - Fri 8:00 to 5:00 Physical Therapy PCMH: No PCMH: No Belser Jr, Roy PT Floyd, Whitney PT Provider ID: 1486761 Provider ID: 2270182 Crisp, Brian PA Gender: Male Provider ID: 953681 Gender: Female Pro-Motion Physical Therapy Pro-Motion Physical Therapy Gender: Male 148 Sauls St, B Mcleod Orthopaedics Florence 148 Sauls St, Ste B Lake City, SC 29560 Lake City, SC 29560-2677 1005 E Cheves St (843) 374-0185 Florence, SC 29506-2707 (843) 374-0185 Fax: (843) 374-0189 Fax: (843) 374-0189 (843) 777-7900 Mon - Thu 8:00 to 6:00 Fax: (843) 777-7925 Mon - Thu 8:00 to 6:00 Fri 8:00 to 12:00 Fri 8:00 to 12:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 173 38642781

Allied Providers Florence Physical Therapy - cont. Mcabee, Andrew PT Physician Assistant Provider ID: 2298968 Heyward, James PT Gender: Male Armstrong, Morgan PA Provider ID: 773124 Pro-Motion Physical Therapy Provider ID: 2318744 Gender: Male 610 W Palmetto St Gender: Female Mcleod Regional Medical Center Florence, SC 29501-4302 Mcleod Family Medicine South 555 E Cheves St (843) 407-0377 611 2nd Loop Rd Florence, SC 29506-2617 Fax: (843) 799-1944 Florence, SC 29505-2820 (843) 777-2000 Mon - Thu 8:00 to 6:00 (843) 777-9460 Mon - Fri 9:00 to 5:00 Fri 8:00 to 12:00 Fax: (843) 678-3610 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Huggins, Lauren PT Mcclain, Nicole PT Provider ID: 1432394 Provider ID: 1552572 Black, Neicole PA Gender: Female Gender: Female Provider ID: 1749338 Priority Physical Therapy Pro Motion Physical Therapy Gender: Female 2521 S Cashua Dr 610 W Palmetto St Doctors Care South Irby Florence, SC 29501 Florence, SC 29501-4302 2200 S Irby St (843) 536-4888 (843) 407-0377 Florence, SC 29505-3423 Fax: (843) 799-0992 Fax: (843) 799-1944 (843) 662-9945 Mon - Fri 7:00 to 5:00 Mon - Thu 8:00 to 5:00 Fax: (843) 662-9946 PCMH: No Fri 8:00 to 12:00 Mon - Fri 8:00 to 8:00 PCMH: No PCMH: No Imbeau, Nancy PT Provider ID: 1174514 Poston, Laurie PT Bramblett, Melanie PA Gender: Female Provider ID: 2065664 Provider ID: 1347769 Pro Motion Physical Therapy Gender: Female Gender: Female 148b Sauls St Dynamic Development Mcleod Orthopaedics Lake City, SC 29560 2461 S Hallmark Dr 800 E Cheves St, Ste 480 (843) 374-0185 Florence, SC 29505-3911 Florence, SC 29506-2653 Fax: (843) 374-0189 (843) 229-5813 (843) 777-7900 Mon - Thu 8:00 to 5:00 Fax: (843) 662-3612 Fax: (843) 777-7925 Fri 8:00 to 12:00 Mon - Tue, Thu - Fri 8:00 to 4:00 Mon - Fri 8:00 to 5:00 PCMH: No Wed 8:0 to to 0:0 PCMH: No PCMH: No Imbeau, Nancy PT Bramblett, Melanie PA Provider ID: 1174514 Wyont, Shannon PT Provider ID: 1347769 Gender: Female Provider ID: 773737 Gender: Female Pro-Motion Physical Therapy Of Gender: Female Mcleod Orthopaedics Florence Flor Dynamic Development 1005 E Cheves St 610 W Palmetto St 2461 S Hallmark Dr Florence, SC 29506-2707 Florence, SC 29501 Florence, SC 29505-3911 (843) 777-7900 (843) 407-0377 (843) 229-5813 Fax: (843) 777-7925 Fax: (843) 799-1944 Fax: (843) 662-3612 Mon - Fri 8:00 to 5:00 Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 174 38642781

Allied Providers Florence Physician Assistant - cont. Knippen, Elizabeth PA Pittard, Michelle PA Provider ID: 1206793 Provider ID: 1360876 Edwards III, George PA Gender: Female Gender: Female Provider ID: 1467847 Doctors Care Hoffmeyer Road Mcleod Regional Medical Center Gender: Male 2410 Hoffmeyer Rd 555 E Cheves St Mcleod Orthopaedics Florence Florence, SC 29501-7311 Florence, SC 29506-2617 1005 E Cheves St (843) 662-8182 (843) 777-3717 Florence, SC 29506-2707 Fax: (843) 662-8183 Fax: (843) 777-5035 (843) 777-7900 Mon - Fri 8:00 to 8:00 Mon - Sun 12:00 to 12:00 Fax: (843) 777-7925 Sat - Sun 9:00 to 5:00 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Sims, Whitney PA Lee, Hope PA Provider ID: 2197182 Edwards III, George PA Provider ID: 1779612 Gender: Female Provider ID: 1467847 Gender: Female Mcleod Cardiology Associates Gender: Male Mcleod Urology Associates 101 William H Johnson St, Ste 600 Mcleod Orthopaedics 800 E Cheves St, Ste 350 Florence, SC 29506-2773 800 East Cheves St, Ste 480 Florence, SC 29506-2649 (843) 667-1891 Florence, SC 29506 (843) 777-7555 Fax: (843) 665-2516 (843) 777-7900 Fax: (843) 777-7563 Mon - Fri 8:00 to 5:00 Fax: (843) 777-7925 Mon - Fri 8:00 to 5:00 PCMH: No Mon - Thu 8:00 to 5:00 PCMH: No Fri 8:00 to 2:00 PCMH: No Snapp, Isaac PA Maksin, Michael PA Provider ID: 1276037 Provider ID: 2156026 Gender: Male Finch, Carole PA Gender: Male Genesis Healthcare Inc DBA Olanta Provider ID: 814290 Mcleod Orthopaedics Florence F Gender: Female 1005 E Cheves St 211 S Jones Rd Olanta Family Care Florence, SC 29506-2707 Olanta, SC 29114 211 S Jones Rd (843) 777-7900 (843) 393-9723 Olanta, SC 29114-9705 Fax: (843) 777-7925 Fax: (843) 395-9735 (843) 396-9730 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 395-9735 PCMH: No PCMH: No Mon - Thu 8:00 to 5:00 Fri 8:00 to 12:00 PCMH: No Mitchell, Benjamin PA Stevenson, Robert PA Provider ID: 1756979 Provider ID: 1498822 Gender: Male Gender: Male Hanna, Charlotte PA Mcleod Cardiothoracic Surgical Mcleod Orthopaedics Florence Provider ID: 2397400 Asso 1005 E Cheves St Gender: Female 101 S Ravenel St, Ste 270 Florence, SC 29506-2707 Mcleod Neurological Associates Florence, SC 29506-2624 (843) 777-7900 800 E Cheves St, Ste 380 (843) 777-7020 Fax: (843) 777-7925 Florence, SC 29506-2649 Fax: (843) 664-9545 Mon - Fri 8:00 to 5:00 (843) 665-4104 Mon - Fri 8:00 to 5:00 PCMH: No Fax: (843) 777-7565 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 175 38642781

Allied Providers Florence Physician Assistant - cont. Wicker, Sonia PA Camak, Kelsi LPC Provider ID: 1302358 Provider ID: 2388167 Strickland, Laura PA Gender: Female Gender: Female Provider ID: 1297176 Mcleod Spine Center Hopehealth Fmu Gender: Female 800 E Cheves St, Ste 480 B 121 S Evander Dr Mcleod Spine Center Florence, SC 29506-2653 Florence, SC 29506-4212 800 E Cheves St, Ste 480 B (843) 432-1880 (843) 661-1848 Florence, SC 29506-2653 Fax: (843) 432-1022 Fax: (843) 661-1818 (843) 432-1880 Mon - Fri 8:00 to 5:00 Mon - Tue, Thu - Fri 8:30 to 5:00 Fax: (843) 432-1022 PCMH: No PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No Physician Assistant Family Medicine Cogdell-Quick, Edna LPC Provider ID: 1856900 Thomas, Julie PA Smith, Lisa PA Gender: Female Provider ID: 1769196 Provider ID: 1699251 Hopehealth Inc Gender: Female Gender: Female 600 E Palmetto St Doctors Care South Irby Palmetto Geriatrics LLC Florence, SC 29506-2851 2200 South Irby Street 1831 W Evans St, Ste 315 (843) 667-9414 Florence, SC 29505-3423 Florence, SC 29501-3300 Fax: (843) 667-1362 (843) 662-9945 (843) 679-4999 Mon - Fri 8:00 to 5:00 Fax: (843) 662-9946 Mon - Fri 8:00 to 5:00 PCMH: No Mon - Fri 8:00 to 8:00 PCMH: No PCMH: No Daniels, Prezillic LPC Professional Counselor Provider ID: 2152797 Tohid, Usman PA Bendle, Lakyn LPC Gender: Female Provider ID: 1775109 Wellspring Psychology Group LLC Gender: Male Provider ID: 1723304 Gender: Female 1340 Celebration Blvd 360 N Irby St, # Sr Florence, SC 29501-5585 Florence, SC 29501-2808 Hopehealth Inc 600 E Palmetto St (843) 536-1180 (843) 667-9414 Fax: (843) 536-1116 Fax: (843) 667-1362 Florence, SC 29506-2851 (843) 667-9414 Mon 9:00 to 7:00 Mon - Fri 8:00 to 5:00 Tue - Thu 8:00 to 7:00 PCMH: No Fax: (843) 667-1362 Mon - Fri 7:30 to 5:00 Fri 8:00 to 5:00 PCMH: No PCMH: No Tohid, Usman PA Provider ID: 1775109 Bendle, Lakyn LPC Durant, Kelvin LPC Gender: Male Provider ID: 1787248 Hopehealth Inc Provider ID: 1723304 Gender: Female Gender: Male 600 E Palmetto St A New You Counseling Center LLC Florence, SC 29506-2851 Hopehealth Irby 360 N Irby St 901 W Evans St, Ste B (843) 667-9414 Florence, SC 29501-3441 Fax: (843) 667-1362 Florence, SC 29501-2808 (843) 667-9414 (843) 799-0088 Mon - Fri 7:30 to 5:00 Mon - Fri 9:00 to 6:00 PCMH: No Fax: (843) 667-1362 Mon - Fri 8:00 to 8:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 176 38642781

Allied Providers Florence Professional Counselor - cont. Simon Mcqueen, Ryedenna LPC Speech Therapy Fuller, Clara LPC Provider ID: 1714307 English, Wynne MD Provider ID: 1907910 Gender: Female Provider ID: 776768 Gender: Female Hopehealth Irby Gender: Male Sanders Family Counseling 360 N Irby St Mcleod Regional Med Ctr 2147a Hoffmeyer Rd Florence, SC 29501-2808 555 E Cheves St Florence, SC 29501-4015 (843) 667-9414 Florence, SC 29505 (843) 661-6030 Fax: (843) 667-1362 (843) 777-2196 Mon - Thu 8:00 to 8:00 Mon - Fri 8:00 to 8:00 Mon - Fri 9:00 to 5:00 Fri 10:00 to 5:00 PCMH: No PCMH: No PCMH: No Tunstall, Marsha LPC Grasshoff, Victoria SLP Moore, Christopher LPC Provider ID: 1858581 Provider ID: 773888 Provider ID: 1710849 Gender: Female Gender: Female Gender: Male Hopehealth Inc Its Therapy Inc Hopehealth Irby 600 E Palmetto St 3369 Lupine Dr 360 N Irby St Florence, SC 29506-2851 Florence, SC 29501 Florence, SC 29501-2808 (843) 667-9414 (843) 621-9889 (843) 667-9414 Fax: (843) 667-1362 Fax: (843) 317-9944 Fax: (843) 667-1362 Mon - Fri 7:30 to 5:00 Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 8:00 PCMH: No PCMH: No PCMH: No Speech & Language Pathology Hudley, Jamila SLP Roberts, Kimberly LPC Provider ID: 776590 Provider ID: 1856744 Mcbride, Karen SLP Gender: Female Gender: Female Provider ID: 2066196 Its Therapy Inc The Counseling Center Of Florence Gender: Female 3369 Lupine Dr 616 S Coit St Dynamic Development Florence, SC 29501 Florence, SC 29501-5223 2461 S Hallmark Dr (843) 621-9889 (843) 409-3046 Florence, SC 29505-3911 Fax: (843) 317-9944 Fax: (843) 667-1549 (843) 229-5813 Mon - Fri 9:00 to 5:00 Mon - Thu 7:30 to 7:30 Fax: (843) 229-6623 PCMH: No PCMH: No Mon - Fri 8:00 to 4:00 PCMH: No Little, Elizabeth SLP Simon Mcqueen, Ryedenna LPC Provider ID: 775101 White, Kristin SLP Gender: Female Provider ID: 1714307 Provider ID: 1406198 Speech Pathology Associates Gender: Female Gender: Female 2224 Palm Ct Hopehealth Inc Pee Dee Speech And Hearing Florence, SC 29501 600 E Palmetto St Center (843) 332-7750 Florence, SC 29506-2851 153 E N B Baroody St Fax: (843) 332-7754 (843) 667-9414 Florence, SC 29506 Mon - Fri 8:00 to 5:00 Fax: (843) 667-1362 (843) 662-7802 PCMH: No Mon - Fri 7:30 to 5:00 Fax: (843) 662-5601 PCMH: No Mon - Fri 8:30 to 5:00 Parish, Jan SLP PCMH: No Provider ID: 770306 Gender: Female Mcleod Regional Medical Center 555 E Cheves St Florence, SC 29506 (843) 777-2000 Mon - Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 177 38642781

Allied Providers Florence Speech Therapy - cont. Williams, Leslie LPC Provider ID: 1260935 Stevens, Holly SLP Gender: Female Provider ID: 770024 Hopehealth Inc Gender: Female 600 E Palmetto St Mcleod Regional Med Ctr Florence, SC 29506-2851 555 E Cheves St (843) 667-9414 Florence, SC 29505 Fax: (843) 667-4133 (843) 777-2250 Mon - Fri 7:30 to 5:00 Mon - Fri 9:00 to 5:00 PCMH: No PCMH: No Thoracic Surgery Wightman, Haley SLP Provider ID: 770247 Babb, Yarrow PA Gender: Female Provider ID: 953131 Dynamic Development Gender: Male 2461 S Hallmark Dr Mcleod Cardiothoracic Surgical Florence, SC 29505 Asso (843) 229-5813 101 S Ravenel St, Ste 270 Fax: (843) 662-3612 Florence, SC 29506-2611 Mon - Fri 8:00 to 5:00 (843) 777-7020 PCMH: No Fax: (843) 664-9545 Mon - Fri 8:00 to 5:00 Wightman, Haley SLP PCMH: No Provider ID: 770248 Gender: Female Vascular Surgery Specialty Clinics 555 E Cheves St Moody, Ashley PA Florence, SC 29506 Provider ID: 1144130 (843) 777-4075 Gender: Female Mon - Fri 9:00 to 5:00 Mcleod Vascular Associates PCMH: No 101 S Ravenel St, Ste 230 Florence, SC 29506-2624 (803) 777-7043 Substance Abuse Fax: (803) 777-7041 Kirkland, Marion LPC Mon - Fri 8:00 to 5:00 Provider ID: 1240690 PCMH: No Gender: Male Hopehealth Inc 600 E Palmetto St Florence, SC 29506-2851 (843) 667-9414 Fax: (843) 667-4133 Mon - Fri 7:30 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 178 38642781

Allied Providers Horry Advance Registered Nurse Gray Stanley, Tommi AUD Cardiac Electrophysiology Practitioner Psychiatrist Provider ID: 1250088 Johnson, Katy PA Reid, Maribeth APRN Gender: Female Provider ID: 1045787 Provider ID: 1544289 Cmc ENT Gender: Female Gender: Female 808 Farrar Dr Grand Strand Surgical Specialists Little River Medical Center Conway, SC 29526 933 Medical Cir 1075 Mr Joe White Ave, Ste 101 (843) 347-7300 Myrtle Beach, SC 29572-4116 Myrtle Beach, SC 29577-5658 Fax: (843) 347-8459 (843) 497-7772 (843) 663-8000 Mon - Fri 8:30 to 5:00 Fax: (843) 497-7627 Mon - Fri 8:30 to 5:30 PCMH: No Grand Strand Regional Medical PCMH: No Center Mon - Thu 9:00 to 5:00 Gray Stanley, Tommi AUD Fri 9:00 to 4:00 Advanced Practice Registered Nurse Provider ID: 1367870 PCMH: No Gender: Female Johnston, Virginia APRN Grand Strand Hearing LLC Provider ID: 1579495 1016 2nd Ave N, Ste 102 Cardiology Gender: Female North Myrtle Beach, SC 29582 Georgetown Physician Associates Ll (843) 732-6090 Hardee, Joseph PA 4040 Highway 17, Unit 104 Fax: (843) 491-3573 Provider ID: 921408 Murrells Inlet, SC 29576-5098 Tue - Wed, Fri 8:00 to 5:00 Gender: Male (843) 652-8150 PCMH: No Pee Dee Cardiology Associates Fax: (843) 652-8151 3980 Highway 9 E, Ste 220 Mon - Fri 8:30 to 5:00 Little River, SC 29566-8164 PCMH: No Lee, Alexandria AUD (843) 390-0877 Provider ID: 1530385 Fax: (843) 390-0881 Gender: Female Mon - Fri 8:00 to 5:00 Reynolds, Lauren CRNA Cmc ENT PCMH: No Provider ID: 1782413 808 Farrar Dr Gender: Female Conway, SC 29526-8747 Strand Gi Associates Pa (843) 347-7300 Hardee, Joseph PA 945 82nd Pkwy, Ste 3a Fax: (843) 347-8459 Provider ID: 921408 Myrtle Beach, SC 29572-4612 Mon - Thu 8:30 to 5:00 Gender: Male (843) 449-3381 Fri 8:30 to 1:00 Pee Dee Cardiology Associates Fax: (843) 629-9621 PCMH: No Loris Mon - Thu 8:00 to 5:00 3485 Mitchell St Fri 8:00 to 10:0 Loris, SC 29569-8164 PCMH: No Levy, Marissa AUD (843) 756-7029 Provider ID: 2356981 Fax: (843) 756-7033 Gender: Female Mon - Fri 8:00 to 5:00 Audiology Cmc ENT PCMH: No Benbow, Pamela AUD 808 Farrar Dr Provider ID: 773382 Conway, SC 29526 Jackson, Tamiko APRN Gender: Female (843) 347-7300 Provider ID: 1422985 Hearing Health Care Fax: (843) 347-8459 Gender: Female 5913 N Kings Hwy Mon - Thu 8:00 to 5:00 Grand Strand Surgical Specialists Myrtle Beach, SC 29577 Fri 8:00 to 1:00 8210 Devon Ct (843) 497-6156 PCMH: No Myrtle Beach, SC 29572 Mon - Fri 9:00 to 5:00 (843) 497-7772 PCMH: No Fax: (843) 848-7530 Mon - Thu 8:30 to 5:00 Fri 8:30 to 4:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 179 38642781

Allied Providers Horry Certified Nurse Anesthetist Fowler, Tiffany APRN Pacheco, Stephanie CRNA Provider ID: 2029288 Allen, Scott CRNA Gender: Female Provider ID: 2028725 Provider ID: 1533062 Cmc Women's Health Conway Gender: Female Gender: Male 2376 Cypress Cir, Ste 200 Strand Gi Associates Strand Gi Associates Pa Conway, SC 29526-8994 945 82nd Pkwy, Ste 3a 7900 N Kings Hwy (843) 347-7216 Myrtle Beach, SC 29572-4612 Myrtle Beach, SC 29572-3055 Fax: (843) 347-7218 (843) 449-3381 (843) 449-3381 Mon - Fri 8:00 to 5:00 Fax: (843) 449-9721 Fax: (843) 449-9721 PCMH: No Mon - Thu 8:00 to 5:00 Mon - Thu 8:00 to 5:00 Fri 8:00 to 1:00 Fri 8:00 to 1:00 PCMH: No PCMH: No Harrold, Bernadette CRNA Provider ID: 1803697 Post, Moira CRNA Christian LA Touche, Jeanine Gender: Female Provider ID: 2144987 CRNA Strand Gi Associates Gender: Female Provider ID: 2051620 945 82nd Pkwy, Ste 3a Mcleod Loris Seacoast Gender: Female Myrtle Beach, SC 29572-4612 3655 Mitchell St Strand Gi Associates (843) 449-3381 Loris, SC 29569-2827 945 82nd Pkwy, Ste 3a Fax: (843) 692-9621 (843) 777-5240 Myrtle Beach, SC 29572-4612 Mon - Thu 8:00 to 5:00 Fax: (843) 777-5572 (843) 449-3381 Fri 8:00 to 1:00 Mon - Sun 12:00 to 12:00 Fax: (843) 449-9721 PCMH: No PCMH: No Mon - Thu 8:00 to 5:00 Fri 8:00 to 1:00 Jones, Karen CRNA Certified Nurse Midwife PCMH: No Provider ID: 1832823 Gender: Female Andrada, Marta CNM Ciancione, Jerome CRNA Mcleod Oncology Hematology Provider ID: 1432402 Provider ID: 1740124 Associ Gender: Female Gender: Male 3980 Highway 9 E, Ste 300 Health Care Partners Of South Strand Gi Associates Pa Little River, SC 29566-8165 Carol 945 82nd Pkwy, Ste 3a (843) 366-3891 1608 Main St Myrtle Beach, SC 29572-4612 Fax: (843) 366-3892 Conway, SC 29526-3572 (843) 449-3381 Mon - Fri 8:00 to 5:00 (843) 248-4700 Fax: (843) 692-9621 PCMH: No Fax: (843) 248-3145 Mon - Thu 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Sat 8:00 to 12:00 Fri 8:00 to 1:00 Mullaney, Courtney CRNA PCMH: No PCMH: No Provider ID: 2189666 Forrest, James CRNA Gender: Female Clinical Social Work Provider ID: 2306989 Strand Gi Associates Pa Beck, Marcia CSW Gender: Male 945 82nd Pkwy, Ste 3a Provider ID: 1607196 Strand Gi Associates Myrtle Beach, SC 29572-4612 Gender: Female 7900 N Kings Hwy (843) 449-3381 Marcia Beck Myrtle Beach, SC 29572-3055 Fax: (843) 692-9621 1021 2nd Ave N, Ste 5 (843) 449-3381 Mon - Thu 8:00 to 5:00 North Myrtle Beach, SC 29582-3200 Fax: (843) 449-9721 Fri 8:00 to 1:00 (843) 280-2280 Mon - Thu 8:00 to 5:00 PCMH: No Fax: (253) 252-8792 Fri 8:00 to 2:00 Mon - Fri 10:00 to 7:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 180 38642781

Allied Providers Horry Clinical Social Work - cont. Moore, Adele CNP Stone, Kaitlin APRN Provider ID: 1190990 Provider ID: 1265705 Davis, Rochelle LCSW Gender: Female Gender: Female Provider ID: 1541192 Roper St. Francis Physician Partner Georgetown Physician Associates Gender: Female 4835 Hwy 17 N Bypass Ste B LLC Little River Medical Center Inc Murrells Inlet, SC 29576-5037 4301 Dick Pond Rd 4220 Carolina Exchange Dr (843) 723-8823 Myrtle Beach, SC 29588-6807 Myrtle Beach, SC 29579-4220 Fax: (843) 766-6551 (843) 652-8100 (843) 663-8000 Mon - Fri 9:00 to 5:00 Fax: (843) 652-8122 Mon - Fri 8:00 to 7:00 PCMH: No Mon - Thu 7:30 to 6:00 PCMH: No Fri 8:00 to 5:00 Robinson, Christopher PA PCMH: No Durable Medical Equipment Provider ID: 1191058 Harris, Larry PA Gender: Male Surratt, Susan ARNP Provider ID: 1190819 Roper St. Francis Physician Partner Provider ID: 1206872 Gender: Male 4630 Highway 17 Gender: Female Roper St Francis Physician Partners Murrells Inlet, SC 29576-5016 Doctors Care Surfside 4823 Hwy 17 N, Ste B (843) 958-1281 1600 Highway 17 N Murrells Inlet, SC 29576-5037 Fax: (843) 958-1278 Myrtle Beach, SC 29575-6015 (843) 723-8823 Mon - Fri 9:00 to 5:00 (843) 238-1461 Fax: (843) 766-6551 PCMH: No Fax: (843) 828-0622 Mon - Fri 9:00 to 5:00 Mon - Sun 8:00 to 8:00 PCMH: No Ear Nose & Throat PCMH: No Mauldin, Kristen PA Landers, Summer PA Vincent, Heather PA Provider ID: 1298535 Provider ID: 1421882 Provider ID: 1190925 Gender: Female Gender: Female Gender: Female Charleston ENT Associates LLC Waterway Primary Care LLC Roper St Francis Physician Partners 4835 Highway 17, Ste B 4823 Hwy 17 N, Ste B 4237 River Hills Dr, Ste 150 Murrells Inlet, SC 29576 Little River, SC 29566 Murrells Inlet, SC 29576-5037 (843) 766-7103 (843) 723-8823 (843) 281-2778 Mon - Fri 8:00 to 5:00 Fax: (843) 281-2785 Fax: (843) 766-6551 PCMH: No Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Family Practice Mctavish, Joseph PA Eaton, Carol PA Wilson, Beverly APRN Provider ID: 1190978 Provider ID: 1260913 Provider ID: 814499 Gender: Male Gender: Female Gender: Female Roper St Francis Physician Partners Cpg Family Medicine Little River Medical Center Inc 4823 Hwy 17 N, Ste B 5010 Carolina Forest Blvd 4303 Live Oak Dr Murrells Inlet, SC 29576-5037 Myrtle Beach, SC 29579 Little River, SC 29566-9138 (843) 723-8823 (843) 236-2700 (843) 663-8000 Fax: (843) 766-6551 Fax: (843) 236-2726 Fax: (843) 663-8100 Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 Mon - Fri 8:30 to 5:30 PCMH: No PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 181 38642781

Allied Providers Horry Federally Qualified Health Center Bush, Crystal CSW Mannain, Taanya LSW Provider ID: 1839664 Provider ID: 1244389 Andrada, Marta CNM Gender: Female Gender: Female Provider ID: 1432402 Little River Medical Center Inc Little River Medical Center Inc Gender: Female 7724 N Kings Hwy 1075 Mr Joe White Ave, Ste 101 Health Care Partners Of South Myrtle Beach, SC 29572-3041 Myrtle Beach, SC 29577-5658 Carol (843) 663-8000 (843) 663-8000 1608 Main St Fax: (843) 663-8256 Fax: (843) 839-2052 Conway, SC 29526-3572 Mon - Fri 8:30 to 5:30 Mon - Fri 8:30 to 5:30 (843) 248-4700 PCMH: No PCMH: No Fax: (843) 248-3145 Mon - Fri 8:00 to 5:00 Sat 8:00 to 12:00 Davis, Rochelle LCSW Mannain, Taanya LSW PCMH: No Provider ID: 1541192 Provider ID: 1244389 Gender: Female Gender: Female Little River Medical Center Inc Little River Medical Center Inc Bush, Crystal CSW 4220 Carolina Exchange Dr 3236 Holmestown Rd Provider ID: 1839664 Myrtle Beach, SC 29579-4220 Myrtle Beach, SC 29588 Gender: Female (843) 663-8000 (843) 663-8000 Little River Medical Center Inc Mon - Fri 8:00 to 7:00 Fax: (843) 663-8092 3817 Main St PCMH: No Mon - Fri 8:30 to 5:30 Loris, SC 29569-3017 PCMH: No (843) 663-8000 Fax: (843) 756-6828 Elliott, Alexis LSW Mon - Tue 8:00 to 7:00 Provider ID: 2137276 Mannain, Taanya LSW Wed 8:00 to 70:0 Gender: Female Provider ID: 1244389 Thu 8:30 to 9:00 Health Cate Partners Of South Gender: Female Fri 8:30 to 5:30 Carol Little River Medical Center Inc PCMH: No 1608 Main St 3817 Main St Conway, SC 29526-3572 Loris, SC 29569-3017 (843) 488-6030 (843) 663-8000 Bush, Crystal CSW Fax: (877) 322-0181 Fax: (843) 756-6828 Provider ID: 1839664 Mon - Fri 8:00 to 5:00 Mon - Fri 8:30 to 5:30 Gender: Female Sat 8:00 to 12:00 PCMH: No Little River Medical Center Inc PCMH: No 4220 Carolina Exchange Dr Myrtle Beach, SC 29579-4220 Mannain, Taanya LSW (843) 663-8000 Freeman, Katherine APRN Provider ID: 1244389 Mon - Fri 8:00 to 7:00 Provider ID: 2168064 Gender: Female PCMH: No Gender: Female Little River Medical Center Inc Health Care Partners Of Sc 4220 Carolina Exchange Dr 1608 Main St Myrtle Beach, SC 29579 Bush, Crystal CSW Conway, SC 29526-3572 (843) 663-8000 Provider ID: 1839664 (843) 488-6030 Fax: (843) 663-8123 Gender: Female Fax: (877) 322-0181 Mon - Fri 8:30 to 5:30 Little River Medical Center Inc Mon - Fri 9:00 to 5:00 PCMH: No 4303 Live Oak Dr Sat 8:00 to 12:00 Little River, SC 29566-9138 PCMH: No (843) 663-8000 Mannain, Taanya LSW Fax: (843) 663-8123 Provider ID: 1244389 Mon, Wed 8:00 to 7:00 Gender: Female Tue, Thu - Fri 8:00 to 6:00 Little River Medical Center Inc PCMH: No 4303 Live Oak Dr Little River, SC 29566-9138 (843) 663-8000 Fax: (843) 663-8123 Mon - Fri 8:30 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 182 38642781

Allied Providers Horry Federally Qualified Health Center - Payne, Tricia CSW Payne, Tricia CSW cont. Provider ID: 1243325 Provider ID: 1243325 Gender: Female Gender: Female Mannain, Taanya LSW Little River Medical Center Inc Little River Medical Center Inc Provider ID: 1244389 1075 Mr Joe White Ave 7724 N Kings Hwy Gender: Female Myrtle Beach, SC 29577-5658 Myrtle Beach, SC 29572-3041 Little River Medical Center Inc (843) 663-8000 (843) 663-8000 7724 N Kings Hwy Fax: (843) 839-2052 Fax: (843) 663-8258 Myrtle Beach, SC 29572-3041 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 (843) 663-8000 PCMH: No PCMH: No Fax: (843) 663-8256 Mon - Fri 8:30 to 5:30 Payne, Tricia CSW Reid, Maribeth APRN PCMH: No Provider ID: 1243325 Provider ID: 1544289 Gender: Female Gender: Female Mannain, Taanya LSW Little River Medical Center Inc Little River Medical Center Provider ID: 1244389 3236 Holmestown Rd 1075 Mr Joe White Ave, Ste 101 Gender: Female Myrtle Beach, SC 29569-3017 Myrtle Beach, SC 29577-5658 Little River Medical Center Inc (843) 663-8000 (843) 663-8000 7726 N Kings Hwy Fax: (843) 663-8092 Mon - Fri 8:30 to 5:30 Myrtle Beach, SC 29572-3041 Mon - Fri 8:00 to 5:00 PCMH: No (843) 663-8000 PCMH: No Fax: (843) 663-8256 Rollings, Jan LCSW Mon - Fri 8:30 to 5:30 Payne, Tricia CSW Provider ID: 1530927 PCMH: No Provider ID: 1243325 Gender: Female Gender: Female Little River Medical Center Painter, Autumn APRN Little River Medical Center Inc 3817 Main St Provider ID: 2148094 3817 Main St Loris, SC 29569-3017 Gender: Female Loris, SC 29569-3017 (843) 663-8000 Health Care Partners Of Sc Inc. (843) 663-8000 Fax: (843) 663-8113 1608 Main St Fax: (843) 756-6828 Mon - Fri 8:30 to 5:30 Conway, SC 29526-3572 Mon - Fri 8:00 to 5:00 PCMH: No (843) 488-6030 PCMH: No Fax: (877) 322-0181 Rollings, Jan LCSW Mon - Fri 8:00 to 5:00 Payne, Tricia CSW Provider ID: 1530927 Sat 8:00 to 12:00 Provider ID: 1243325 Gender: Female PCMH: No Gender: Female Little River Medical Center Inc Little River Medical Center Inc 1075 Mr Joe White Ave, Unit 101 Painter, Autumn APRN 4220 Carolina Exchange Dr, Suite 101 Myrtle Beach, SC 29577-5658 Provider ID: 2148094 Myrtle Beach, SC 28579 (843) 663-8000 Gender: Female (843) 663-8000 Fax: (843) 663-8113 Health Care Partners Of Sc Inc. Fax: (843) 663-8123 Mon - Fri 8:30 to 5:30 243 Singleton Ridge Rd, Units E F Mon - Fri 8:00 to 5:00 PCMH: No Conway, SC 29526 PCMH: No (843) 488-6030 Rollings, Jan LCSW Fax: (877) 322-0181 Payne, Tricia CSW Provider ID: 1530927 Mon - Fri 8:00 to 5:00 Provider ID: 1243325 Gender: Female Sat 8:00 to 12:00 Gender: Female Little River Medical Center Inc PCMH: No Little River Medical Center Inc 3236 Holmestown Rd, Unit E1 4303 Live Oak Dr Myrtle Beach, SC 29588-7495 Little River, SC 29566-9138 (843) 663-8000 (843) 663-8000 Fax: (843) 663-8113 Fax: (843) 663-8123 Mon - Fri 8:30 to 5:30 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 183 38642781

Allied Providers Horry Federally Qualified Health Center - Thompson, Donna LCSW Thompson, Donna LCSW cont. Provider ID: 1118250 Provider ID: 1118250 Gender: Female Gender: Female Rollings, Jan LCSW Little River Medical Center Inc Little River Medical Center Inc Provider ID: 1530927 1075 Mr Joe White Ave, Ste 101 7726 N Kings Hwy Gender: Female Myrtle Beach, SC 29577-5658 Myrtle Beach, SC 29572-3041 Little River Medical Center Inc (843) 663-8000 (843) 663-8000 4220 Carolina Exchange Dr Fax: (843) 839-2052 Fax: (843) 663-8258 Myrtle Beach, SC 29579 Mon - Fri 8:30 to 5:30 Mon - Fri 8:30 to 5:30 (843) 663-8000 PCMH: No PCMH: No Fax: (843) 663-8113 Mon - Fri 8:30 to 5:30 Thompson, Donna LCSW Ward, Mary LPC PCMH: No Provider ID: 1118250 Provider ID: 1445506 Gender: Female Gender: Female Rollings, Jan LCSW Little River Medical Center Inc Little River Medical Center Inc Provider ID: 1530927 3236 Holmestown Rd, Ste E1 1075 Mr Joe White Ave, Unit 101 Gender: Female Loris, SC 29569 Myrtle Beach, SC 29577-5658 Little River Medical Center Inc (843) 663-8000 (843) 663-8000 4303 Live Oak Dr Fax: (843) 663-8092 Fax: (843) 663-8123 Little River, SC 29566-9138 Mon - Fri 8:30 to 5:30 Mon - Fri 8:30 to 5:30 (843) 663-8000 PCMH: No PCMH: No Fax: (843) 663-8166 Mon - Fri 8:30 to 5:30 Thompson, Donna LCSW Ward, Mary LPC PCMH: No Provider ID: 1118250 Provider ID: 1445506 Gender: Female Gender: Female Rollings, Jan LCSW Little River Medical Center Inc Little River Medical Center Inc Provider ID: 1530927 3817 Main St 3236 Holmestown Rd, Unit E1 Gender: Female Loris, SC 29569-3017 Myrtle Beach, SC 29588-7495 Little River Medical Center Inc (843) 663-8000 (843) 663-8000 7724 N Kings Hwy Fax: (843) 756-6828 Fax: (843) 663-8123 Myrtle Beach, SC 29572 Mon - Fri 8:30 to 5:30 Mon - Fri 8:30 to 5:30 (843) 663-8000 PCMH: No PCMH: No Fax: (843) 663-8113 Mon - Fri 8:30 to 5:30 Thompson, Donna LCSW Ward, Mary LPC PCMH: No Provider ID: 1118250 Provider ID: 1445506 Gender: Female Gender: Female Teague, Allen LPC Little River Medical Center Inc Little River Medical Center Inc Provider ID: 774912 4303 Live Oak Dr 3817 Main St Gender: Male Little River, SC 29566-9138 Loris, SC 29569-3017 Little River Medical Center (843) 663-8000 (843) 663-8000 1075 Mr Joe White Ave, Ste 101 Fax: (843) 663-8123 Fax: (843) 663-8123 Myrtle Beach, SC 29577-5657 Mon - Fri 8:30 to 5:30 Mon - Fri 8:30 to 5:30 (843) 663-1013 PCMH: No PCMH: No Fax: (843) 663-1018 Mon - Fri 8:30 to 5:30 Thompson, Donna LCSW Ward, Mary LPC PCMH: No Provider ID: 1118250 Provider ID: 1445506 Gender: Female Gender: Female Little River Medical Center Inc Little River Medical Center Inc 7724 N Kings Hwy 4220 Carolina Exchange Dr Myrtle Beach, SC 29572-3041 Myrtle Beach, SC 29579-4220 (843) 663-8000 (843) 663-8000 Fax: (843) 663-8256 Fax: (843) 663-8123 Mon - Fri 8:30 to 5:30 Mon - Fri 8:30 to 5:30 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 184 38642781

Allied Providers Horry Federally Qualified Health Center - Wiltshire, Charlotte RD General Surgery cont. Provider ID: 1143423 Gender: Female Brown, Daniel PA Ward, Mary LPC Little River Medical Center Inc Provider ID: 1467844 Provider ID: 1445506 3236 Holmestown Rd, Ste E1 Gender: Male Gender: Female Myrtle Beach, SC 29588-7495 Grand Strand Surgical Specialists Little River Medical Center Inc (843) 663-8000 849 82nd Pkwy 4303 Live Oak Dr Fax: (843) 663-8092 Myrtle Beach, SC 29572 Little River, SC 29566-9138 Mon - Fri 8:30 to 5:30 (703) 732-3104 (843) 663-8000 PCMH: No Fax: (855) 884-9422 Fax: (843) 663-8123 Mon - Thu 8:00 to 5:00 Fri 8:00 to 4:00 Mon - Fri 9:00 to 5:00 Gastroenterology PCMH: No PCMH: No Gwyer, Carrie APRN Ward, Mary LPC Provider ID: 1285323 Burgess, La'asha PA Provider ID: 1445506 Gender: Female Provider ID: 1466693 Gender: Female Georgetown Physician Associates Ll Gender: Female Little River Medical Center Inc 4040 Highway 17, Ste 302 Grand Strand Surgical Specialists L 7724 N Kings Hwy Murrells Inlet, SC 29576-5098 849 82nd Pkwy Myrtle Beach, SC 29572-3041 (843) 652-8290 Myrtle Beach, SC 29572-4614 (843) 663-8000 Fax: (843) 652-8299 (843) 497-6348 Fax: (843) 663-8123 Mon - Fri 8:30 to 5:00 Fax: (843) 497-6351 Mon - Fri 8:30 to 5:30 PCMH: No Mon - Thu 8:00 to 5:00 PCMH: No Fri 8:00 to 4:00 Gwyer, Carrie APRN PCMH: No Ward, Mary LPC Provider ID: 1285323 Provider ID: 1445506 Gender: Female Cote, Lydia PA Gender: Female Georgetown Physician Associates Ll Provider ID: 1084039 Little River Medical Center Inc 4301 Dick Pond Rd Gender: Female 7726 N Kings Hwy Myrtle Beach, SC 29588-6807 Grand Strand Specialty Associates Myrtle Beach, SC 29572-3041 (843) 652-8290 849 82nd Pkwy (843) 663-8000 Fax: (843) 652-8299 Myrtle Beach, SC 29572 Fax: (843) 663-8123 Mon - Fri 8:30 to 5:00 (843) 497-6348 Mon - Fri 8:30 to 5:30 PCMH: No Fax: (843) 497-6351 PCMH: No Mon - Thu 8:00 to 5:00 General Practice Fri 8:00 to 1:00 PCMH: No Wilson, Beverly APRN Hinman, Candace PA Provider ID: 814499 Provider ID: 1107314 Ventura, Katherine PA Gender: Female Gender: Female Little River Medical Center Inc Provider ID: 1474502 Tidelands Health Family Medicine Gender: Female 4303 Live Oak Dr 2347 Hwy 17 Bus South Little River, SC 29566-9138 Grand Strand Surgical Specialistsl Garden City, SC 29576-7611 849 82nd Pkwy (843) 663-8000 (843) 357-2443 Fax: (843) 663-8100 Myrtle Beach, SC 29572 Fax: (843) 357-2132 (843) 497-6348 Mon - Fri 8:30 to 5:30 Mon - Fri 8:00 to 5:30 PCMH: No Fax: (843) 497-6351 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 185 38642781

Allied Providers Horry Internal Medicine Krutke, Amanda CNP Bush, Crystal CSW Provider ID: 1190911 Provider ID: 1839664 Garrett, Nicole PA Gender: Female Gender: Female Provider ID: 1183693 Roper St Francis Physician Partners Little River Medical Center Inc Gender: Female 4630 Highway 17 4220 Carolina Exchange Dr Grand Strand Surgical Specialists Murrells Inlet, SC 29576-5016 Myrtle Beach, SC 29579-4220 8210 Devon Ct (843) 235-8333 (843) 663-8000 Myrtle Beach, SC 29572 Fax: (843) 235-8334 Mon - Fri 8:00 to 7:00 (843) 497-7772 Mon - Fri 9:00 to 5:00 PCMH: No Fax: (843) 848-7530 PCMH: No Mon - Thu 9:00 to 5:00 Fri 9:00 to 4:00 Bush, Crystal CSW PCMH: No Licensed Clinical Social Worker Provider ID: 1839664 Gender: Female Bergeron, Shawn LCSW Little River Medical Center Inc Gwyer, Carrie APRN Provider ID: 901229 4303 Live Oak Dr Provider ID: 1285323 Gender: Male Little River, SC 29566-9138 Gender: Female Bergeron Counseling Services (843) 663-8000 Georgetown Physician Associates Ll 1107 48th Ave N, Ste 114 Fax: (843) 663-8123 4040 Highway 17, Ste 302 Myrtle Beach, SC 29577-5980 Mon, Wed 8:00 to 7:00 Murrells Inlet, SC 29576-5098 (843) 318-6619 Tue, Thu - Fri 8:00 to 6:00 (843) 652-8290 Fax: (843) 215-6329 PCMH: No Fax: (843) 652-8299 Mon - Fri 9:00 to 5:00 Mon - Fri 8:30 to 5:00 PCMH: No PCMH: No Bush, Crystal CSW Provider ID: 1839664 Bovey, Diantha LSW Gender: Female Gwyer, Carrie APRN Provider ID: 2148081 Little River Medical Center Inc Provider ID: 1285323 Gender: Female 7724 N Kings Hwy Gender: Female Coastal Haven Counseling LLC Myrtle Beach, SC 29572-3041 Georgetown Physician Associates Ll 220 Ronnie Ct, Ste 2 (843) 663-8000 4301 Dick Pond Rd Myrtle Beach, SC 29579-4192 Fax: (843) 663-8256 Myrtle Beach, SC 29588-6807 (843) 945-0346 Mon - Fri 8:30 to 5:30 (843) 652-8290 Fax: (843) 432-3091 PCMH: No Fax: (843) 652-8299 Mon - Fri 9:00 to 10:00 Mon - Fri 8:30 to 5:00 Sat - Sun 9:00 to 5:00 PCMH: No PCMH: No Bush, Crystal CSW Provider ID: 1839664 Gender: Female Johnson, Katy PA Bovey, Diantha LSW Little River Medical Center Inc Provider ID: 1045787 Provider ID: 2148081 3817 Main St Gender: Female Gender: Female Loris, SC 29569-3017 Grand Strand Surgical Specialists Coastal Haven Counseling LLC (843) 663-8000 933 Medical Cir 3100 Dick Pond Rd, Ste D2 Fax: (843) 756-6828 Myrtle Beach, SC 29572-4116 Myrtle Beach, SC 29588-7286 Mon - Tue 8:00 to 7:00 (843) 497-7772 (843) 945-0346 Wed 8:00 to 70:0 Fax: (843) 497-7627 Fax: (834) 343-2309 Thu 8:30 to 9:00 Grand Strand Regional Medical Mon - Thu 9:00 to 10:00 Fri 8:30 to 5:30 Center Fri 9:0 to to 00:0 PCMH: No Mon - Thu 9:00 to 5:00 Sat - Sun 9:00 to 5:00 Fri 9:00 to 4:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 186 38642781

Allied Providers Horry Licensed Clinical Social Worker - Lewis, Kellie CSW Nelsen, Cara LCSW cont. Provider ID: 1174516 Provider ID: 1186600 Gender: Female Gender: Female Fenner, Lynda LCSW Real Counseling LLC Real Counseling LLC Provider ID: 1434920 9403 Highway 707, Ste B 9403 Highway 707, Ste B Gender: Female Myrtle Beach, SC 29588 Myrtle Beach, SC 29588 Pivotal Solutions LLC (843) 273-0077 (843) 273-0077 800 Legion St Fax: (843) 273-0075 Fax: (843) 273-0075 Conway, SC 29526 Mon - Thu 9:00 to 4:00 Mon - Sat 8:00 to 8:00 (843) 236-1157 Fri 9:00 to 2:00 PCMH: No Fax: (844) 599-6538 Sat 9:00 to 12:00 Mon - Fri 9:00 to 5:00 PCMH: No Nixon, Bevin CSW PCMH: No Provider ID: 2119830 Lyons, Ruth LCSW Gender: Female Jackson, Debbie CSW Provider ID: 1281818 Counseling Center Of Sayebrook Provider ID: 2348403 Gender: Female 106 Lansford Pl, Ste 202 Gender: Female Missing Link Counseling Myrtle Beach, SC 29588-6979 Coastal Haven Counseling LLC 1297 Professional Dr, Ste 101b (843) 213-2659 220 Ronnie Ct, Ste 2 Myrtle Beach, SC 29577 Fax: (843) 213-6231 Myrtle Beach, SC 29579-4192 (843) 232-7550 Mon - Thu 8:00 to 6:00 (843) 945-0346 Fax: (843) 712-1425 Fri 8:00 to 2:00 Fax: (843) 432-3091 Mon - Wed 8:00 to 6:00 PCMH: No Mon - Fri 8:00 to 10:00 Thu 8:00 to 7:00 Sat 8:00 to 7:00 Fri 8:00 to 5:00 Norman, Mary CSW Sun 9:00 to 5:00 PCMH: No Provider ID: 1281106 PCMH: No Gender: Female Mcfarland, Lindsey CSW Real Counseling LLC Kelly, Kathleen CSW Provider ID: 2348400 621 Sea Mountain Hwy Provider ID: 2324171 Gender: Female North Myrtle Beach, SC 29582 Gender: Female Coastal Haven Counseling LLC (843) 273-0077 Sandhills Intergrated Care Inc. 220 Ronnie Ct, Ste 2 Fax: (843) 273-0075 3993 Meeting St Myrtle Beach, SC 29579-4192 Mon - Fri 9:00 to 6:00 Loris, SC 29569-3053 (843) 945-0346 PCMH: No (843) 756-3008 Fax: (843) 432-3091 Fax: (843) 756-3128 Mon - Fri 8:00 to 10:00 Norman, Mary CSW Mon - Fri 8:00 to 5:00 Sat 8:00 to 5:00 Provider ID: 1281106 PCMH: No Sun 9:00 to 3:00 Gender: Female PCMH: No Real Counseling LLC Lewis, Kellie CSW 9403 Highway 707, Ste B Provider ID: 1174516 Nelsen, Cara LCSW Myrtle Beach, SC 29588 Gender: Female Provider ID: 1186600 (843) 273-0077 Real Counseling LLC Gender: Female Fax: (843) 273-0075 621 Sea Mountain Hwy Real Counseling LLC Mon - Thu 8:00 to 5:00 North Myrtle Beach, SC 29582 621 Sea Mountain Hwy Fri 8:00 to 4:00 (843) 273-0077 North Myrtle Beach, SC 29582 PCMH: No Fax: (843) 273-0075 (843) 273-0077 Mon - Fri 9:00 to 5:00 Fax: (843) 273-0075 PCMH: No Mon - Sat 8:00 to 8:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 187 38642781

Allied Providers Horry Licensed Clinical Social Worker - Payne, Tricia CSW Rollings, Jan LCSW cont. Provider ID: 1243325 Provider ID: 1530927 Gender: Female Gender: Female Payne, Tricia CSW Little River Medical Center Inc Little River Medical Center Inc Provider ID: 1243325 4303 Live Oak Dr 1075 Mr Joe White Ave, Unit 101 Gender: Female Little River, SC 29566-9138 Myrtle Beach, SC 29577-5658 Little River Medical Center Inc (843) 663-8000 (843) 663-8000 1075 Mr Joe White Ave Fax: (843) 663-8123 Fax: (843) 663-8113 Myrtle Beach, SC 29577-5658 Mon - Fri 8:00 to 5:00 Mon - Fri 8:30 to 5:30 (843) 663-8000 PCMH: No PCMH: No Fax: (843) 839-2052 Mon - Fri 8:00 to 5:00 Payne, Tricia CSW Rollings, Jan LCSW PCMH: No Provider ID: 1243325 Provider ID: 1530927 Gender: Female Gender: Female Payne, Tricia CSW Little River Medical Center Inc Little River Medical Center Inc Provider ID: 1243325 7724 N Kings Hwy 3236 Holmestown Rd, Unit E1 Gender: Female Myrtle Beach, SC 29572-3041 Myrtle Beach, SC 29588-7495 Little River Medical Center Inc (843) 663-8000 (843) 663-8000 3236 Holmestown Rd Fax: (843) 663-8258 Fax: (843) 663-8113 Myrtle Beach, SC 29569-3017 Mon - Fri 8:00 to 5:00 Mon - Fri 8:30 to 5:30 (843) 663-8000 PCMH: No PCMH: No Fax: (843) 663-8092 Mon - Fri 8:00 to 5:00 Robinette, Lester CSW Rollings, Jan LCSW PCMH: No Provider ID: 2119804 Provider ID: 1530927 Gender: Male Gender: Female Payne, Tricia CSW Coastal Haven Counseling LLC Little River Medical Center Inc Provider ID: 1243325 220 Ronnie Ct, Ste 2 4220 Carolina Exchange Dr Gender: Female Myrtle Beach, SC 29579-4192 Myrtle Beach, SC 29579 Little River Medical Center Inc (843) 945-0346 (843) 663-8000 3817 Main St Fax: (843) 432-3091 Fax: (843) 663-8113 Loris, SC 29569-3017 Mon - Thu 9:00 to 7:00 Mon - Fri 8:30 to 5:30 (843) 663-8000 Fri 9:00 to 1:00 PCMH: No Fax: (843) 756-6828 Sat 9:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No Rollings, Jan LCSW PCMH: No Provider ID: 1530927 Rollings, Jan LCSW Gender: Female Payne, Tricia CSW Provider ID: 1530927 Little River Medical Center Inc Provider ID: 1243325 Gender: Female 4303 Live Oak Dr Gender: Female Little River Medical Center Little River, SC 29566-9138 Little River Medical Center Inc 3817 Main St (843) 663-8000 4220 Carolina Exchange Dr, Suite 101 Loris, SC 29569-3017 Fax: (843) 663-8166 Myrtle Beach, SC 28579 (843) 663-8000 Mon - Fri 8:30 to 5:30 (843) 663-8000 Fax: (843) 663-8113 PCMH: No Fax: (843) 663-8123 Mon - Fri 8:30 to 5:30 Mon - Fri 8:00 to 5:00 PCMH: No Rollings, Jan LCSW PCMH: No Provider ID: 1530927 Gender: Female Little River Medical Center Inc 7724 N Kings Hwy Myrtle Beach, SC 29572 (843) 663-8000 Fax: (843) 663-8113 Mon - Fri 8:30 to 5:30 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 188 38642781

Allied Providers Horry Licensed Clinical Social Worker - Thompson, Donna LCSW Licensed Independent Social Worker cont. Provider ID: 1118250 Gender: Female Elliott, Alexis LSW Roman, John LCSW Little River Medical Center Inc Provider ID: 2137276 Provider ID: 1274088 3817 Main St Gender: Female Gender: Male Loris, SC 29569-3017 Health Cate Partners Of South Roman Clinical Consulting LLC (843) 663-8000 Carol 917 Broadway St, Ste 3 Fax: (843) 756-6828 1608 Main St Myrtle Beach, SC 29577-3718 Mon - Fri 8:30 to 5:30 Conway, SC 29526-3572 (843) 582-7887 PCMH: No (843) 488-6030 Fax: (843) 800-0061 Fax: (877) 322-0181 Mon - Fri 8:00 to 5:00 Mon - Fri 9:00 to 8:00 Thompson, Donna LCSW PCMH: No Sat 8:00 to 12:00 Provider ID: 1118250 PCMH: No Gender: Female Seitzinger, Veronica CSW Little River Medical Center Inc Provider ID: 2371172 4303 Live Oak Dr Licensed Marriage And Family Gender: Female Little River, SC 29566-9138 Therapist Coastal Haven Counseling LLC (843) 663-8000 220 Ronnie Ct, Ste 2 Fax: (843) 663-8123 Beres, Danielle LMFT Myrtle Beach, SC 29579-4192 Mon - Fri 8:30 to 5:30 Provider ID: 1821040 (843) 945-0346 PCMH: No Gender: Female Fax: (843) 432-3091 Sandhills Intergrated Care Inc 3993 Meeting St Mon - Thu, Sun 8:00 to 10:0 Thompson, Donna LCSW Fri 8:00 to 5:00 Loris, SC 29569-3053 Provider ID: 1118250 (336) 253-5286 Sat 9:00 to 5:00 Gender: Female PCMH: No Mon - Fri 8:30 to 7:00 Little River Medical Center Inc PCMH: No 7724 N Kings Hwy Thompson, Donna LCSW Myrtle Beach, SC 29572-3041 Provider ID: 1118250 (843) 663-8000 Carter, Robert LMFT Gender: Female Fax: (843) 663-8256 Provider ID: 1271024 Little River Medical Center Inc Mon - Fri 8:30 to 5:30 Gender: Male 1075 Mr Joe White Ave, Ste 101 PCMH: No The Center For Counseling And Myrtle Beach, SC 29577-5658 Welln 110 Ye Olde Kings Hwy (843) 663-8000 Thompson, Donna LCSW Fax: (843) 839-2052 North Myrtle Beach, SC 29582 Provider ID: 1118250 (843) 663-0770 Mon - Fri 8:30 to 5:30 Gender: Female PCMH: No Fax: (843) 663-0772 Little River Medical Center Inc Mon - Fri 8:30 to 6:00 7726 N Kings Hwy PCMH: No Thompson, Donna LCSW Myrtle Beach, SC 29572-3041 Provider ID: 1118250 (843) 663-8000 Gender: Female Fax: (843) 663-8258 Carter, Robert LMFT Little River Medical Center Inc Mon - Fri 8:30 to 5:30 Provider ID: 1271024 3236 Holmestown Rd, Ste E1 PCMH: No Gender: Male Loris, SC 29569 The Center For Counseling And (843) 663-8000 Welln Fax: (843) 663-8092 3505 Main St Mon - Fri 8:30 to 5:30 Loris, SC 29569-2931 PCMH: No (843) 663-0770 Fax: (843) 663-0772 Mon - Fri 9:00 to 7:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 189 38642781

Allied Providers Horry Licensed Marriage And Family Anderson, Jill LPC Bogle, Roberta LPC Therapist - cont. Provider ID: 1565166 Provider ID: 915727 Gender: Female Gender: Female Carter, Robert LMFT Coastal Haven Counseling LLC The Center For Counseling And Provider ID: 1271024 3100 Dick Pond Rd, Ste D2 Welln Gender: Male Myrtle Beach, SC 29588-7286 4466 Holmestown Rd The Center For Counseling And (843) 945-0346 Myrtle Beach, SC 29588-7490 Welln Fax: (843) 432-3091 (843) 663-0770 4466 Holmestown Rd Mon - Tue, Fri 9:00 to 7:00 Fax: (843) 663-0772 Myrtle Beach, SC 29588-7490 Wed 9:00 to 9:00 Mon - Fri 9:00 to 7:00 (843) 663-0770 Thu 9:00 to 5:00 PCMH: No Fax: (843) 663-0772 Sat 10:00 to 3:00 Mon - Fri 9:00 to 7:00 PCMH: No Brown, Catherine LPC PCMH: No Provider ID: 969275 Bidell, Jill LPC Gender: Female Licensed Master Social Worker Provider ID: 2227365 Catherine M Brown/More Than Gender: Female Conque Mottey, Kristen CSW Caren Stewart And Associates LLC 1604 Main St, Unit A Provider ID: 2373588 800 Legion St, Ste 101d Conway, SC 29526-3572 Gender: Female Conway, SC 29526-4825 (843) 488-1877 Health Care Partners Of South (704) 460-2317 Fax: (843) 488-1887 Carol Fax: (843) 962-5277 Mon - Thu 9:00 to 5:00 1608 Main St Mon - Tue, Thu 9:00 to 5:00 Fri 9:00 to 2:00 Conway, SC 29526-3572 PCMH: No PCMH: No (843) 488-6030 Fax: (877) 322-0181 Mon - Fri 8:00 to 5:00 Bogle, Roberta LPC Bulsza, Susan LPC Sat 8:00 to 12:00 Provider ID: 915727 Provider ID: 901778 PCMH: No Gender: Female Gender: Female The Center For Counseling And 2513 N Oak St, Ste 208 Welln Myrtle Beach, SC 29577-3250 Licensed Professional Counselor 110 Ye Olde Kings Hwy (843) 333-6767 Anderson, Jill LPC North Myrtle Beach, SC 29582-4384 Fax: (843) 903-5053 Provider ID: 1565166 (843) 663-0770 Mon 9:00 to 1:00 Gender: Female Fax: (843) 663-0772 Tue - Thu 9:00 to 6:00 Coastal Haven Counseling LLC Mon - Thu 9:00 to 7:00 Fri 1:00 to 5:00 220 Ronnie Ct, Ste 2 Fri 9:00 to 2:00 PCMH: No Myrtle Beach, SC 29579-4192 PCMH: No (843) 945-0346 Burgess, Gloria LPC Fax: (843) 432-3091 Bogle, Roberta LPC Provider ID: 1712835 Mon - Tue, Fri 9:00 to 7:00 Provider ID: 915727 Gender: Female Wed 9:00 to 9:00 Gender: Female Pivotal Solutions Thu 9:00 to 5:00 The Center For Counseling And 400 George Bishop Pkwy Sat 10:00 to 3:00 Welln Myrtle Beach, SC 29579 PCMH: No 3505 Main St (843) 236-1157 Loris, SC 29569-2931 Fax: (844) 599-6538 (843) 663-0770 Mon - Fri 9:00 to 5:00 Fax: (843) 663-0772 PCMH: No Mon - Fri 9:00 to 7:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 190 38642781

Allied Providers Horry Licensed Professional Counselor - Cox, Demeatra LPC Everhart Lachnicht, Ashley LPC cont. Provider ID: 1564008 Gender: Female Provider ID: 1175266 Calhoun, Howard LPC Pivotal Solutions LLC Gender: Female Provider ID: 1306894 400 George Bishop Pkwy Real Counseling LLC Gender: Male Myrtle Beach, SC 29579 621 Sea Mountain Hwy Behavior Balance (843) 236-1157 North Myrtle Beach, SC 29582 586 Highway 701 N, Suite A Fax: (844) 599-6538 (843) 273-0077 Loris, SC 29569 Mon - Fri 9:00 to 5:00 Fax: (843) 273-0075 (843) 756-7171 PCMH: No Mon - Tue, Thu - Fri 9:00 to 5:00 Fax: (843) 756-7176 Wed 9:00 to 7:00 Mon - Fri 9:00 to 5:00 Davis, Nancy LPC Sat 9:00 to 12:00 PCMH: No Provider ID: 1177477 PCMH: No Gender: Female Campbell, Thomas LPC Real Counseling LLC Everhart Lachnicht, Ashley LPC Provider ID: 1326346 621 Sea Mountain Hwy Gender: Male North Myrtle Beach, SC 29582 Provider ID: 1175266 Real Counseling LLC (843) 273-0077 Gender: Female 621 Sea Mountain Hwy Fax: (843) 273-0075 Real Counseling LLC North Myrtle Beach, SC 29582 Mon - Sat 8:00 to 8:00 9403 Highway 707, Ste B (843) 273-0077 PCMH: No Myrtle Beach, SC 29588 Fax: (843) 273-0075 (843) 273-0077 Mon - Fri 9:00 to 6:00 Fax: (843) 273-0075 Sat 9:00 to 12:00 Davis, Nancy LPC Mon - Tue, Thu - Fri 9:00 to 5:00 PCMH: No Provider ID: 1177477 Wed 9:00 to 7:00 Gender: Female Sat 9:00 to 12:00 Real Counseling LLC PCMH: No Campbell, Thomas LPC 9403 Highway 707, Ste B Provider ID: 1326346 Myrtle Beach, SC 29588 Gender: Male (843) 273-0077 Fleming, Stephanie LPC Real Counseling LLC Fax: (843) 273-0075 Provider ID: 1009868 9403 Highway 707, Ste B Mon - Sat 8:00 to 8:00 Gender: Female Myrtle Beach, SC 29588 PCMH: No Rivertown Counseling Associates (843) 273-0077 LLC Fax: (843) 273-0075 607 Main St Mon - Fri 9:00 to 6:00 Dennis, Brandi LPC Conway, SC 29526-4339 Sat 9:00 to 12:00 Provider ID: 2104363 (843) 488-1877 PCMH: No Gender: Female Fax: (843) 488-1887 Carolina Pediatric Counseling Mon 8:00 to 5:00 600 N Azalea Dr, Ste 103 Tue, Thu 9:00 to 5:00 Cantley, Amy LMHC Surfside Beach, SC 29575-5020 Wed 9:00 to 12:00 Provider ID: 919633 (843) 468-1850 PCMH: No Gender: Female Fax: (843) 407-4265 A Piece Of Mind Counseling And Mon - Sat 8:00 to 6:00 Cons PCMH: No 3944 Highway 17, Unit 7 Murrells Inlet, SC 29576-5094 (843) 318-0380 Fax: (843) 947-0812 Mon - Fri 8:00 to 9:00 Sat - Sun 8:00 to 6:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 191 38642781

Allied Providers Horry Licensed Professional Counselor - Harper, Phillip LPC John Deloaceh cont. Provider ID: 1605042 Provider ID: 927204 Gender: Male Christian Counseling Clinic LLC Fortune, Jane LPC Center For Counseling And 3959 Highway 17 Provider ID: 1032297 Wellness Murrells Inlet, SC 29576-5014 Gender: Female 110 Ye Olde Kings Hwy (843) 299-0509 Jane Fortune Counseling LLC North Myrtle Beach, SC 29582 Fax: (843) 299-0510 4999 Carolna Frst Blvd, Ste 22c (843) 663-0770 Mon - Fri 9:00 to 8:00 Myrtle Beach, SC 29579-3588 Fax: (843) 663-0772 PCMH: No (843) 268-4980 Mon - Fri 8:00 to 6:00 Fax: (888) 727-1946 PCMH: No King, Ellen LPC Mon 9:00 to 1:00 Provider ID: 1238294 Wed 1:00 to 6:00 Harper, Phillip LPC Gender: Female Thu 10:00 to 6:00 Provider ID: 1605042 Tlc Counseling LLC Fri 10:00 to 3:00 Gender: Male 289 Highway 90 E, Unit H PCMH: No The Center For Counseling And Little River, SC 29566 Welln (843) 685-0998 Frasier, Colisha LPC 3505 Main St Mon - Fri 10:00 to 7:00 Provider ID: 1040037 Loris, SC 29569-2931 PCMH: No Gender: Female (843) 663-0770 Mccarthy Counseling Associates Pa Fax: (843) 663-0772 Long, Shannon LPC 4603 Oleander Dr, Ste 1 Mon - Fri 9:00 to 7:00 Provider ID: 1444009 Myrtle Beach, SC 29577-5738 PCMH: No Gender: Female (843) 497-5240 Waves Of Change Counseling Fax: (843) 497-1129 Harper, Phillip LPC Services Mon - Thu 8:00 to 6:00 Provider ID: 1605042 2022 Laurel Oak Ct Fri 8:00 to 2:00 Gender: Male Myrtle Beach, SC 29579 PCMH: No The Center For Counseling And (843) 333-2416 Welln Fax: (843) 443-4229 Goodall, Kristina LPC 4466 Holmestown Rd Mon - Fri 9:00 to 5:00 Provider ID: 1861887 Myrtle Beach, SC 29588-7490 PCMH: No Gender: Female (843) 663-0770 Surfside Counseling LLC Fax: (843) 663-0772 Lookadoo, Brian LPC 1500 Highway 17 Business, Ste 104 Mon - Fri 9:00 to 7:00 Provider ID: 1344704 Surfside Beach, SC 29575 PCMH: No Gender: Male (843) 333-8624 Real Counseling LLC Fax: (888) 274-0122 Harrington, Teressa LPC 9403 Highway 707, Ste B Mon - Fri 10:00 to 8:00 Provider ID: 813368 Myrtle Beach, SC 29588-7758 Sat 9:00 to 12:00 Gender: Female (843) 273-0077 PCMH: No Tth Services Inc Fax: (843) 273-0075 3959 Hwy 17, Ste A Mon - Fri 9:00 to 6:00 Goyeneche, Paola LPC Murrells Inlet, SC 29576-5014 Sat 9:00 to 12:00 Provider ID: 1722042 (843) 325-6410 PCMH: No Gender: Female Fax: (888) 455-1889 Coastal Haven Counseling LLC Mon - Fri 8:00 to 6:00 220 Ronnie Ct, Ste 2 PCMH: No Myrtle Beach, SC 29579-4192 (843) 945-0346 Fax: (843) 432-3091 Mon, Wed, Fri 9:00 to 5:00 Tue, Thu 9:00 to 7:00 Sat 10:00 to 3:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 192 38642781

Allied Providers Horry Licensed Professional Counselor - Malkasian, Paul LPC Martin, Laura LPC cont. Provider ID: 1630695 Provider ID: 1520169 Gender: Male Gender: Female Lookadoo, Brian LPC Ctr Counseling The Center For Counseling And Provider ID: 1862698 1261 Highway 501e, Ste F Welln Gender: Male Conway, SC 29526-8362 3505 Main St Surfside Counseling (508) 254-0066 Loris, SC 29569-2931 1500 N Hwy 17 Business, Ste 104 Fax: (866) 220-0907 (843) 663-0770 Surfside Beach, SC 29575 Mon - Fri 8:00 to 5:00 Mon - Fri 9:00 to 7:00 (843) 333-8624 PCMH: No PCMH: No Fax: (888) 274-0122 Mon - Fri 9:00 to 7:00 Malkasian, Paul LPC Martin, Laura LPC Sat 9:00 to 12:00 Provider ID: 1630695 Provider ID: 1520169 PCMH: No Gender: Male Gender: Female Ctr Counseling The Center For Counseling And Lynch, Bruce LPC 5182 Horry Dr, Ste A Welln Provider ID: 1059064 Murrells Inlet, SC 29576-5240 4466 Holmestown Rd Gender: Male (843) 353-7388 Myrtle Beach, SC 29588-7490 The Center For Counseling And Fax: (508) 796-2420 (843) 663-0770 Welln Mon - Tue, Thu 10:00 to 9:00 Fax: (843) 663-0772 110 Ye Olde Kings Hwy Wed 12:00 to 8:00 Mon - Fri 9:00 to 7:00 North Myrtle Beach, SC 29582-4384 Fri 10:00 to 5:00 PCMH: No (843) 663-0770 PCMH: No Fax: (843) 663-0772 Mccarthy, Robert LPC Mon - Fri 8:00 to 8:00 Malkasian, Loren LPC Provider ID: 1033981 PCMH: No Provider ID: 1838310 Gender: Male Gender: Female Mccarthy Counseling Associates Pa Lynch, Bruce LPC Ctr Counseling 4603 Oleander Dr, Ste 1 And 2 Provider ID: 1059064 1261 E Highway 501, Ste F Myrtle Beach, SC 29577-5738 Gender: Male Conway, SC 29526-8362 (843) 497-5240 The Center For Counseling And (508) 254-0066 Fax: (843) 497-1129 Welln Fax: (866) 220-0907 Mon - Fri 8:00 to 6:00 3505 Main St Mon - Thu 10:00 to 9:00 PCMH: No Loris, SC 29569-2931 Fri 9:00 to 8:00 (843) 663-0770 PCMH: No Mcgonigal, Jennifer LPC Mon - Fri 9:00 to 7:00 Provider ID: 1599187 PCMH: No Martin, Laura LPC Gender: Female Provider ID: 1520169 Coastal Haven Counseling Lynch, Bruce LPC Gender: Female 220 Ronnie Ct, Ste 2 Provider ID: 1059064 The Center For Counseling And Myrtle Beach, SC 29579 Gender: Male Welln (803) 896-4658 The Center For Counseling And 110 Ye Olde Kings Hwy Fax: (843) 432-3091 Welln North Myrtle Beach, SC 29582 Mon, Wed 9:00 to 5:00 4466 Holmestown Rd (843) 663-0770 Tue, Thu - Fri 9:00 to 7:00 Myrtle Beach, SC 29588-7490 Fax: (843) 663-0772 Sat 10:00 to 3:00 (843) 663-0770 Mon - Thu 8:00 to 6:00 PCMH: No Mon - Fri 9:00 to 7:00 Fri 8:00 to 3:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 193 38642781

Allied Providers Horry Licensed Professional Counselor - Pickett, Michael LPC Stutler, Tammy LPC cont. Provider ID: 1651246 Provider ID: 1780626 Gender: Male Gender: Female Mcgonigal, Jennifer LPC Coastal Haven Counseling LLC Coastal Haven Counseling LLC Provider ID: 1599187 3100 Dick Pond Rd, Ste D2 220 Ronnie Ct, Ste 2 Gender: Female Myrtle Beach, SC 29588-7286 Myrtle Beach, SC 29579-4192 Coastal Haven Counseling (843) 945-0346 (843) 945-0346 3100 Dick Pond Rd, Ste D2 Fax: (843) 432-3091 Fax: (843) 432-3091 Myrtle Beach, SC 29588 Mon, Wed, Fri 9:00 to 5:00 Mon - Fri 9:00 to 5:00 (843) 945-0346 Tue, Thu 9:00 to 7:00 PCMH: No Fax: (843) 432-3091 Sat 10:00 to 3:00 Mon, Wed, Fri 9:00 to 5:00 PCMH: No Teague, Allen LPC Tue, Thu 9:00 to 7:00 Provider ID: 774912 Sat 10:00 to 3:00 Pickett, Michael LPC Gender: Male PCMH: No Provider ID: 1651246 Little River Medical Center Gender: Male 1075 Mr Joe White Ave, Ste 101 Mercer, Amanda LPC Coastal Haven Counseling Myrtle Beach, SC 29577-5657 Provider ID: 2069405 220 Ronnie Ct, Ste 2 (843) 663-1013 Gender: Female Myrtle Beach, SC 29579-4192 Fax: (843) 663-1018 The Counseling Center Of (843) 945-0346 Mon - Fri 8:30 to 5:30 Sayebrook Fax: (843) 432-3091 PCMH: No 106 Lansford Pl, Ste 202 Mon, Wed 9:00 to 5:00 Myrtle Beach, SC 29588-6979 Tue, Thu 9:00 to 7:00 Underwood, Timothy LPC (843) 213-2659 Fri 10:00 to 3:00 Provider ID: 1021934 Fax: (843) 213-6231 PCMH: No Gender: Male Mon - Thu 8:00 to 6:00 Timothy Underwood Fri 8:00 to 12:00 Stewart, Caren LPC 1511 9th Ave, Ste C PCMH: No Provider ID: 2227479 Conway, SC 29526-4126 Gender: Female (843) 488-1894 Onley Livingston, Angel LPC Caren Stewart & Associates PLLC Fax: (843) 491-4023 Provider ID: 1340730 800 Legion St, Ste 101d Mon - Fri 8:00 to 5:00 Gender: Female Conway, SC 29526-4825 PCMH: No House Of Abba LLC (704) 460-2317 620 Singleton Ridge Rd, Ste 101 Fax: (843) 962-5277 Unger, Patricia LPC Conway, SC 29526 Mon 5:00 to 5:00 Provider ID: 1432733 (843) 353-6216 Tue - Thu 9:00 to 5:00 Gender: Female Fax: (843) 349-0140 Fri 8:30 to 5:00 Tth Services Mon - Wed 9:00 to 6:00 Sun 9:00 to 4:00 3959 Hw 17 Fri 9:00 to 12:00 PCMH: No Murrells Inlet, SC 29576 PCMH: No (843) 299-0509 Stutler, Tammy LPC Fax: (843) 299-0510 Partridge, Heather LPC Provider ID: 1500970 Mon - Thu 9:00 to 8:00 Provider ID: 1515282 Gender: Female Fri 9:00 to 5:00 Gender: Female Real Counseling LLC PCMH: No Tidelands Health Family Medicine 9403 Hwy 707, Ste B 4320 Holmestown Rd Myrtle Beach, SC 29588 Myrtle Beach, SC 29588 (843) 273-0077 (843) 652-8440 Fax: (843) 273-0075 Fax: (843) 652-8441 Mon - Fri 9:00 to 6:00 Mon - Fri 8:00 to 5:00 Sat 9:00 to 1:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 194 38642781

Allied Providers Horry Licensed Professional Counselor - Ward, Mary LPC Licensed Social Worker cont. Provider ID: 1445506 Gender: Female Mannain, Taanya LSW Ward, Mary LPC Little River Medical Center Inc Provider ID: 1244389 Provider ID: 1445506 4303 Live Oak Dr Gender: Female Gender: Female Little River, SC 29566-9138 Little River Medical Center Inc Little River Medical Center Inc (843) 663-8000 3236 Holmestown Rd 1075 Mr Joe White Ave, Unit 101 Fax: (843) 663-8123 Myrtle Beach, SC 29588 Myrtle Beach, SC 29577-5658 Mon - Fri 9:00 to 5:00 (843) 663-8000 (843) 663-8000 PCMH: No Fax: (843) 663-8092 Fax: (843) 663-8123 Mon - Fri 8:30 to 5:30 PCMH: No Mon - Fri 8:30 to 5:30 Ward, Mary LPC PCMH: No Provider ID: 1445506 Gender: Female Mannain, Taanya LSW Ward, Mary LPC Little River Medical Center Inc Provider ID: 1244389 Provider ID: 1445506 7724 N Kings Hwy Gender: Female Gender: Female Myrtle Beach, SC 29572-3041 Little River Medical Center Inc Little River Medical Center Inc (843) 663-8000 3817 Main St 3236 Holmestown Rd, Unit E1 Fax: (843) 663-8123 Loris, SC 29569-3017 Myrtle Beach, SC 29588-7495 Mon - Fri 8:30 to 5:30 (843) 663-8000 (843) 663-8000 PCMH: No Fax: (843) 756-6828 Fax: (843) 663-8123 Mon - Fri 8:30 to 5:30 PCMH: No Mon - Fri 8:30 to 5:30 Ward, Mary LPC PCMH: No Provider ID: 1445506 Gender: Female Mannain, Taanya LSW Ward, Mary LPC Little River Medical Center Inc Provider ID: 1244389 Provider ID: 1445506 7726 N Kings Hwy Gender: Female Gender: Female Myrtle Beach, SC 29572-3041 Little River Medical Center Inc Little River Medical Center Inc (843) 663-8000 4220 Carolina Exchange Dr 3817 Main St Fax: (843) 663-8123 Myrtle Beach, SC 29579 Loris, SC 29569-3017 Mon - Fri 8:30 to 5:30 (843) 663-8000 (843) 663-8000 PCMH: No Fax: (843) 663-8123 Fax: (843) 663-8123 Mon - Fri 8:30 to 5:30 PCMH: No Mon - Fri 8:30 to 5:30 Whitman, Gretchen LPC PCMH: No Provider ID: 2104444 Gender: Female Mannain, Taanya LSW Ward, Mary LPC Carolina Pediatric Counseling Provider ID: 1244389 Provider ID: 1445506 600 N Azalea Dr, Ste 103 Gender: Female Gender: Female Surfside Beach, SC 29575-5020 Little River Medical Center Inc Little River Medical Center Inc (843) 468-1850 4303 Live Oak Dr 4220 Carolina Exchange Dr Fax: (843) 407-4265 Little River, SC 29566-9138 Myrtle Beach, SC 29579-4220 Mon - Sat 8:00 to 6:00 (843) 663-8000 (843) 663-8000 PCMH: No Fax: (843) 663-8123 Fax: (843) 663-8123 Mon - Fri 8:30 to 5:00 PCMH: No Mon - Fri 8:30 to 5:30 Wilkinson, Laura LPC PCMH: No Provider ID: 1241392 Gender: Female Real Counseling LLC 6215 South Carolina Hwy 707 Myrtle Beach, SC 29588 (843) 273-0077 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 195 38642781

Allied Providers Horry Licensed Social Worker - cont. Neurosurgery Barnett, Andrietta APRN Provider ID: 2324177 Mannain, Taanya LSW Denittis, Felicia PA Gender: Female Provider ID: 1244389 Provider ID: 1269923 Sandhills Intergrated Care Inc. Gender: Female Gender: Female 3993 Meeting St Little River Medical Center Inc Grand Strand Specialty Associates L Loris, SC 29569-3053 7724 N Kings Hwy 849 82nd Pkwy (843) 756-3008 Myrtle Beach, SC 29572-3041 Myrtle Beach, SC 29572 Fax: (843) 756-3128 (843) 663-8000 (843) 449-2336 Mon - Fri 9:00 to 5:00 Fax: (843) 663-8256 Fax: (843) 497-6351 PCMH: No Mon - Fri 8:30 to 5:30 Mon - Thu 8:00 to 5:00 PCMH: No Fri 8:00 to 3:00 PCMH: No Batten, Ashley APRN Provider ID: 2318890 Mannain, Taanya LSW Gender: Female Provider ID: 1244389 Mczeke, Kathryn APRN Mcleod Health Loris Seacoast Gender: Female Provider ID: 1334457 3655 Mitchell St Little River Medical Center Inc Gender: Female Loris, SC 29569-2827 7726 N Kings Hwy Grand Strand Specialty Associates (843) 777-5240 Myrtle Beach, SC 29572-3041 849 82nd Pkwy Fax: (843) 777-5572 (843) 663-8000 Myrtle Beach, SC 29572 Mon - Sun 12:00 to 12:00 Fax: (843) 663-8256 (843) 497-6348 PCMH: No Mon - Fri 8:30 to 5:30 Fax: (849) 497-0625 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Bell, Virginia APRN Provider ID: 2189747 Mannain, Taanya LSW Gender: Female Provider ID: 1244389 Nurse Practitioner Palmetto Primary Care Physicians Gender: Female 912 Inlet Square Dr Little River Medical Center Inc Aiken, Sheryl APRN Provider ID: 1522548 Murrells Inlt, SC 29576-7812 1075 Mr Joe White Ave, Ste 101 (843) 651-4111 Myrtle Beach, SC 29577-5658 Gender: Female Georgetown Physician Associates Fax: (843) 492-4666 (843) 663-8000 Mon - Thu 8:00 to 5:00 Fax: (843) 839-2052 LLC 4301 Dick Pond Rd Fri 8:00 to 1:00 Mon - Fri 8:30 to 5:30 PCMH: No PCMH: No Myrtle Beach, SC 29588-6807 (843) 235-3131 Mon - Fri 9:00 to 5:00 Brinegar, Angela APRN Neurology PCMH: No Provider ID: 1977113 Sheth, Rasesh PA Gender: Female Provider ID: 1281822 Alley, Ashley APRN Associated Medical Specialists Pa D Gender: Male Provider ID: 2224305 8121 Rourk St Grand Strand Specialty Associates Gender: Female Myrtle Beach, SC 29572-4128 849 82nd Pkwy Grand Strand Surgical Specialists (843) 692-5000 Myrtle Beach, SC 29572 849 82nd Pkwy Fax: (843) 692-5010 (843) 497-6348 Myrtle Beach, SC 29572-4614 Mon - Thu 7:30 to 5:00 Fax: (843) 497-6351 (843) 497-6348 Fri 7:30 to 3:00 Mon - Thu 8:00 to 5:00 Fax: (843) 497-6351 Sat - Sun 8:00 to 12:00 Fri 8:00 to 3:00 Mon - Fri 8:30 to 5:00 PCMH: No PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 196 38642781

Allied Providers Horry Nurse Practitioner - cont. Brusyanina, Svetlana APRN Crago, Ashley APRN Provider ID: 2144349 Provider ID: 1990195 Brown, Rhonda CNP Gender: Female Gender: Female Provider ID: 1190695 Atlantic Urology Clinics Cpg Pediatrics At Carolina Forest Gender: Female 3600 Sea Mountain Hwy, Ste B 4022 Postal Way, Ste C Roper St. Francis After Hours Care- Little River, SC 29566-8161 Myrtle Beach, SC 29579-3537 912 Inlet Square Dr, Ste A (943) 280-5151 (843) 903-4111 Murrells Inlet, SC 29576-7812 Fax: (843) 399-9596 Fax: (843) 903-4242 (843) 651-4111 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 651-1047 PCMH: No PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No Brusyanina, Svetlana APRN Cribb, Shannon APRN Provider ID: 2144349 Provider ID: 2235411 Brown, Julia APRN Gender: Female Gender: Female Provider ID: 1340723 Atlantic Urology Clinics Grand Strand Heart Vascular Speci Gender: Female 3600 Sea Mountain Hwy, Ste D 920 Doug White Dr, Ste 510 Sc House Calls Inc Little River, SC 29566-8161 Myrtle Beach, SC 29572-4183 1400 Main St (843) 390-8521 (843) 497-7772 Conway, SC 29526-3567 Fax: (843) 399-8932 Fax: (843) 497-7627 (843) 488-0101 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 488-3130 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Brusyanina, Svetlana APRN Crowell, Jacqueline APRN Provider ID: 2144349 Provider ID: 2022789 Brown, Kaitlyn PA Gender: Female Gender: Female Provider ID: 2322792 Atlantic Urology Clinics Grand Strand Surgical Specialists Gender: Female 5046 Highway 17 Byp S, Ste 200 849 82nd Pkwy Cmc ENT Myrtle Beach, SC 29588-4503 Myrtle Beach, SC 29572-4614 808 Farrar Dr (843) 347-2450 (843) 497-6348 Conway, SC 29526 Fax: (843) 293-0448 Fax: (843) 497-6351 (843) 347-7300 Mon - Fri 8:00 to 5:00 Mon - Fri 8:30 to 5:00 Fax: (843) 347-8459 PCMH: No PCMH: No Mon - Thu 8:00 to 5:00 Fri 8:00 to 1:00 PCMH: No Brusyanina, Svetlana APRN Crum, Christopher APRN Provider ID: 1847255 Provider ID: 2144349 Gender: Male Bruno, Tara APRN Gender: Female Strand Infectious Disease Provider ID: 2286677 Atlantic Urology Clinics 831 82nd Pkwy Gender: Female 823 82nd Pkwy Myrtle Beach, SC 29572-4607 Grand Strand Heart Vascular Speci Myrtle Beach, SC 29572-4607 (843) 839-0135 920 Doug White Dr, Ste 150 (843) 449-1010 Fax: (843) 443-2333 Myrtle Beach, SC 29572-4180 Fax: (843) 497-6171 Mon - Fri 8:00 to 5:00 (843) 497-7772 Mon - Fri 8:00 to 5:00 PCMH: No Fax: (843) 497-7627 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Davis Boyd, Tara APRN Collins, Andrew APRN Provider ID: 2222818 Provider ID: 1719951 Gender: Female Gender: Male Coastal Carolina Primary Care LLC Agape Senior Primary Care Inc 5050 Highway 17 Byp S 3300 4th Ave Myrtle Beach, SC 29588-4500 Conway, SC 29527 (843) 839-6090 (800) 491-0909 Fax: (843) 839-6090 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 197 38642781

Allied Providers Horry Nurse Practitioner - cont. Griffith, Mary APRN Howard, Vanessa APRN Provider ID: 1856225 Provider ID: 2294919 Dorr, Rachel APRN Gender: Female Gender: Female Provider ID: 2221941 Coastal Carolina Primary Care LLC Atlantic Urology Clinics LLC Gender: Female 8170 Rourk St, Ste 100 3600 Sea Mountain Hwy, Ste B Liberty Doctors LLC D/B/A Myrtle Beach, SC 29572-4127 Little River, SC 29566-8161 Carolina (843) 236-1950 (843) 399-9696 185 Fresh Dr, Ste A Fax: (843) 236-1952 Fax: (843) 399-9596 Myrtle Beach, SC 29579-4436 Mon - Thu 8:30 to 5:00 Mon - Fri 8:00 to 5:00 (843) 225-8320 Fri 8:30 to 4:00 PCMH: No Fax: (843) 225-3549 PCMH: No Mon - Fri 8:00 to 8:00 Sat - Sun 8:00 to 6:00 Howard, Vanessa APRN PCMH: No Hahn, Kelly APRN Provider ID: 2294919 Provider ID: 2023177 Gender: Female Gender: Female Atlantic Urology Clinics LLC Edwards, Erin ARNP Grand Strand Surgical Specialists 3600 Sea Mountain Hwy, Ste D Provider ID: 2197331 199 Village Center Blvd, Ste 100 Little River, SC 29566-8161 Gender: Female Myrtle Beach, SC 29579-3589 (843) 390-8521 Mcleod Loris Seacoast Surgery (843) 497-6348 Fax: (843) 399-8932 3980 Highway 9 E, Ste 310 Fax: (844) 861-1500 Mon - Fri 8:00 to 5:00 Little River, SC 29566-8165 Mon - Fri 8:00 to 5:00 PCMH: No (843) 399-9774 PCMH: No Fax: (843) 399-8657 Mon - Fri 8:00 to 5:00 Howard, Vanessa APRN PCMH: No Hahn, Kelly APRN Provider ID: 2294919 Provider ID: 2023177 Gender: Female Gender: Female Atlantic Urology Clinics LLC Gilmore, Pamela APRN Grand Strand Surgical Specialists 3617 Casey St, Ste B Provider ID: 1835731 849 82nd Pkwy Loris, SC 29569-2981 Gender: Female Myrtle Beach, SC 29572-4614 (843) 756-6319 Atlantic Urology Clinics LLC (843) 497-6348 Fax: (843) 756-5206 394 Singleton Ridge Rd Fax: (843) 497-6351 Mon - Fri 8:00 to 5:00 Conway, SC 29526-9150 Mon - Fri 8:30 to 5:00 PCMH: No (843) 347-8765 PCMH: No Fax: (843) 347-3499 Mon - Fri 8:00 to 5:00 Hucks, Julia APRN PCMH: No Howard, Vanessa APRN Provider ID: 2013162 Provider ID: 2294919 Gender: Female Gender: Female Cmc Endocrinology Griffith, Mary APRN Atlantic Urology Clinics LLC 2376 Cypress Cir, Ste 202 Provider ID: 1605007 101 Mcleod Health Blvd, Ste 202 Conway, SC 29526-8994 Gender: Female Myrtle Beach, SC 29579-4477 (843) 243-9700 Sc House Calls Inc (843) 236-4949 Fax: (843) 234-6896 809 82nd Pkwy Fax: (843) 239-4746 Mon - Thu 8:30 to 5:00 Myrtle Beach, SC 29572-4607 Mon - Fri 8:00 to 5:00 Fri 8:30 to 1:00 (843) 692-1000 PCMH: No PCMH: No Fax: (843) 353-2581 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 198 38642781

Allied Providers Horry Nurse Practitioner - cont. Moore, Adele CNP Norris, Sarah CNP Provider ID: 1190990 Provider ID: 769353 Jordan, Ginger APRN Gender: Female Gender: Female Provider ID: 1605437 Roper St. Francis Physician Partner Mcleod Family Medicine Gender: Female 4835 Hwy 17 N Bypass Ste B 3418 Casey St Sc House Calls Inc Murrells Inlet, SC 29576-5037 Loris, SC 29569 1400 Main St, Care Management (843) 723-8823 (843) 756-7885 Grand Strand Fax: (843) 766-6551 Fax: (843) 756-7855 Conway, SC 29526-3567 Mon - Fri 9:00 to 5:00 Mon - Fri 9:00 to 5:00 (843) 488-0101 PCMH: No PCMH: No Fax: (843) 331-3979 Mon - Fri 8:00 to 5:00 PCMH: No Neal, Cynthia APRN Patterson, Melissa APRN Provider ID: 1340728 Provider ID: 1531815 Gender: Female Gender: Female Lang, Yolanda APRN Georgetown Physician Associates Georgetown Physician Associates Ll Provider ID: 1876737 LLC 4301 Dick Pond Rd Gender: Female 4301 Dick Pond Rd Myrtle Beach, SC 29588-6807 Cpg Family Medicine At Towne Myrtle Beach, SC 29588-6807 (843) 652-8290 Centre (843) 235-3131 Fax: (843) 652-8299 5010 Carolina Forest Blvd Fax: (843) 237-9797 Mon - Fri 8:30 to 5:00 Myrtle Beach, SC 29579-3579 Mon - Fri 9:00 to 5:00 PCMH: No (843) 903-1010 PCMH: No Fax: (843) 903-1015 Mon - Thu 8:00 to 7:00 Patterson, Melissa APRN Fri 8:00 to 5:00 Niederwerfer, Robin APRN Provider ID: 1531815 PCMH: No Provider ID: 927123 Gender: Female Gender: Female Georgetown Physician Associates Ll Cmc Digestive Health 4040 Highway 17, Unit 302 Lindsay, Christine APRN 2376 Cypress Cir, Ste 203 Murrells Inlet, SC 29576-5098 Conway, SC 29526-8994 (843) 652-8290 Provider ID: 2389304 (843) 347-6038 Fax: (843) 652-8299 Gender: Female Fax: (843) 347-9808 Mon - Fri 8:30 to 5:00 Doctors Care Carolina Forest Mon - Thu 9:00 to 5:00 PCMH: No 200 Middleburg Dr Fri 9:00 to 1:00 Myrtle Beach, SC 29579 PCMH: No (843) 903-6650 Petkovsek, Alexander APRN Fax: (843) 903-0758 Provider ID: 2025660 Mon - Fri 8:00 to 8:00 Norris, Sarah CNP Gender: Male Sat - Sun 9:00 to 5:00 Provider ID: 1646899 Grand Strand Surgical Specialists PCMH: No Gender: Female 849 82nd Pkwy Mcleod Family Medicine Carolina Myrtle Beach, SC 29572-4614 For (843) 497-6348 Moleins, Dawn APRN 101 Mcleod Health Blvd, Ste 201 Fax: (843) 497-6351 Provider ID: 2318954 Myrtle Beach, SC 29579-4477 Mon - Fri 8:30 to 5:00 Gender: Female (843) 646-8001 PCMH: No Mcleod Health Loris Seacoast Fax: (843) 646-8002 3655 Mitchell St Mon - Fri 9:00 to 5:00 Rogers, Lindsey ARNP Loris, SC 29569-2827 PCMH: No (843) 777-5240 Provider ID: 2082840 Fax: (843) 777-5572 Gender: Female Mon - Sun 12:00 to 12:00 Atlantic Urology Clinics LLC PCMH: No 101 Mcleod Health Blvd, Ste 202 Myrtle Beach, SC 29579-4477 (843) 236-4949 Fax: (843) 236-4746 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 199 38642781

Allied Providers Horry Nurse Practitioner - cont. Sloan, Charlotte APRN Trevino, Amanda ARNP Provider ID: 1528194 Provider ID: 2261135 Rogers, Lindsey ARNP Gender: Female Gender: Female Provider ID: 2082840 Sc House Calls Inc Elite Pain Management LLC Gender: Female 1400 Main St 8212 Devon Ct Atlantic Urology Clinics LLC Conway, SC 29526-3567 Myrtle Beach, SC 29572-4178 3600 Sea Mountain Hwy, Ste B (843) 488-0101 (843) 273-0376 Little River, SC 29566-8161 Fax: (843) 331-3979 Fax: (417) 888-0189 (843) 280-5151 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 399-9596 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Smith, Amy APRN Wilson, Ryan APRN Provider ID: 1324638 Provider ID: 2313078 Rogers, Lindsey ARNP Gender: Female Gender: Male Provider ID: 2082840 Georgetown Physician Associates Ll Doctors Care Market Commons Gender: Female 4040 Highway 17, Suite 302 2761 Agnes Ln Atlantic Urology Clinics LLC Murrells Inlet, SC 29576-1209 Myrtle Beach, SC 29577-2029 3600 Sea Mountain Hwy, Ste D (843) 652-8290 (843) 492-2710 Little River, SC 29566-8161 Fax: (843) 652-8299 Fax: (843) 492-2708 (843) 390-8521 Mon - Fri 8:30 to 5:00 Mon - Sun 8:00 to 8:00 Fax: (843) 399-8932 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Smith, Amy APRN Nurse Practitioner Acute Care Provider ID: 1324638 Rogers, Lindsey ARNP Gender: Female Jackson, Kimberly APRN Provider ID: 2082840 Georgetown Physician Associates Ll Provider ID: 1519476 Gender: Female 4301 Dick Pond Rd Gender: Female Atlantic Urology Clinics LLC Myrtle Beach, SC 29588-6807 Lowcountry Infectious Diseases 5046 Highway 17 Byp S, Ste 200 (843) 652-8290 128 Professional Park Dr, Unit B Myrtle Beach, SC 29588-4503 Fax: (843) 652-8299 Conway, SC 29526-9260 (843) 347-2450 Mon - Fri 8:30 to 5:00 (843) 234-8260 Fax: (843) 293-0448 PCMH: No Fax: (843) 449-1605 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 4:30 PCMH: No PCMH: No Staples, Karen APRN Provider ID: 768584 Rogers, Lindsey ARNP Gender: Female Nurse Practitioner Adult Health Provider ID: 2082840 Southern Medical Associates Gender: Female Ganley, Tracey APRN 3418 Casey St Provider ID: 2334499 Atlantic Urology Clinics LLC Loris, SC 29569-2904 823 82nd Pkwy Gender: Female (843) 756-7885 Elite Pain Management Myrtle Beach, SC 29572-4607 Fax: (843) 756-7855 (843) 449-1010 8212 Devon Ct Mon - Fri 9:00 to 5:00 Myrtle Beach, SC 29572-4178 Fax: (843) 497-6171 PCMH: No Mon - Fri 8:00 to 5:00 (843) 273-0376 PCMH: No Fax: (417) 888-0189 Thasitis, Jessica ARNP Mon - Fri 8:00 to 5:00 Provider ID: 2197111 PCMH: No Gender: Female Mcleod Dr. Lindaberry At Carolina F 108 Finnegan Ct Myrtle Beach, SC 29579-4205 (843) 903-9993 Fax: (843) 903-3356 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 200 38642781

Allied Providers Horry Nurse Practitioner Family Medicine Barnett, Andrietta APRN Briggs, Jonathan ARNP Provider ID: 2306209 Provider ID: 2322786 Albury, Vanessa APRN Gender: Female Gender: Male Provider ID: 1591716 Sandhills Intergrated Care Inc Cmc Primary Care Bell Street Gender: Female 3993 Meeting St 903 Bell Street Elite Pain Management LLC Loris, SC 29569-3053 Conway, SC 29526 8212 Devon Ct (843) 756-3008 (843) 488-2111 Myrtle Beach, SC 29572-4178 Fax: (843) 756-3128 Fax: (843) 488-2112 (843) 273-0376 Mon - Fri 9:00 to 5:00 Mon 7:30 to 5:00 Fax: (843) 273-4516 PCMH: No Tue - Thu 8:00 to 5:00 Mon - Fri 8:30 to 5:00 Fri 8:00 to 1:00 PCMH: No Barrett, Jennifer APRN PCMH: No Provider ID: 2136865 Albury, Vanessa APRN Gender: Female Britt, Mary APRN Provider ID: 1591716 Mcleod Cardiology Assoc Loris Provider ID: 2334457 Gender: Female 3485 Mitchell St Gender: Female Elite Pain Management LLC Loris, SC 29569-2823 Elite Pain Management 4237 River Hills Dr, Ste 170 (843) 756-7029 8212 Devon Ct Little River, SC 29566-6446 Fax: (843) 756-7033 Myrtle Beach, SC 29572-4178 (843) 273-0376 Mon - Fri 8:00 to 5:00 (843) 273-0376 Fax: (843) 273-4516 PCMH: No Fax: (417) 888-0189 Mon 8:30 to 5:30 Mon - Fri 8:00 to 5:00 Tue - Fri 8:30 to 4:30 PCMH: No PCMH: No Barrett, Jennifer APRN Provider ID: 2136865 Gender: Female Brown, Tisha APRN Anderson, Alicia APRN Mcleod Cardiology Assoc Seacoast Provider ID: 1550549 Provider ID: 1845544 3980 Highway 9 E, Ste 220 Gender: Female Gender: Female Little River, SC 29566-8164 Seahore Pediatrics PC Liverty Doctors LLC DBA Carolina (843) 390-0877 2828 Bayboro St Fo Fax: (843) 390-0881 Loris, SC 29569-2710 185 Fresh Dr, Ste A Mon - Fri 8:00 to 5:00 (843) 716-2229 Myrtle Beach, SC 29579-4436 PCMH: No Fax: (843) 716-2483 (843) 945-3030 Mon - Fri 8:00 to 5:00 Fax: (843) 492-4479 Belschner, Rebecca APRN Sat 9:00 to 12:00 Mon - Fri 8:00 to 8:00 PCMH: No Sat - Sun 8:00 to 6:00 Provider ID: 2188249 PCMH: No Gender: Female Careteam Plus Brown, Rhonda APRN 100 Professional Park Dr Provider ID: 1637790 Anderson, Alicia APRN Conway, SC 29526-9260 Gender: Female Provider ID: 1845545 (843) 234-8260 Sc House Calls Inc Gender: Female Fax: (843) 234-8224 910 Mount Gilead Rd, Ste B1 Liberty Doctors LLC DBA Surfside Mon, Wed 8:00 to 5:00 Murrells Inlt, SC 29576-7790 Be Tue, Thu 8:00 to 6:00 (800) 491-0909 1945 Glenns Bay Rd Fri 8:00 to 1:00 Fax: (843) 357-3102 Surfside Beach, SC 29575-4833 PCMH: No Mon - Fri 8:00 to 5:00 (843) 650-4006 PCMH: No Fax: (843) 650-4225 Mon - Fri 8:00 to 8:00 Sat - Sun 8:00 to 6:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 201 38642781

Allied Providers Horry Nurse Practitioner Family Medicine - Campbell, Heather APRN Crawford, Stephanie APRN cont. Provider ID: 1705100 Provider ID: 1796029 Gender: Female Gender: Female Butbul Benezra, Vered APRN Doctors Care Pa Cpg Aynor Family Medicine 1113 Church St 1213 Elm St Provider ID: 2291412 Conway, SC 29526 Aynor, SC 29511-3320 Gender: Female (843) 248-6269 (843) 358-5806 Life In A Blender Family Medicine Fax: (843) 248-0535 Fax: (843) 358-9205 132 Pro Park Dr, Unit A Mon - Sun 8:00 to 8:00 Mon - Thu 7:30 to 6:00 Conway, SC 29526-9268 PCMH: No Fri 7:30 to 5:00 (843) 347-4900 PCMH: No Fax: (843) 347-4901 Cook, Helen APRN Mon - Thu 7:30 to 5:00 Provider ID: 1640150 Crum, Christopher APRN Fri 7:30 to 3:00 Gender: Female Provider ID: 2140562 Sat 8:30 to 12:00 Sc House Calls Inc Gender: Male PCMH: No 3300 4th Ave Careteam Plus Conway, SC 29527-6002 100 Professional Park Dr Byrd, Mary APRN (800) 491-0909 Conway, SC 29526-9260 Provider ID: 1057884 Mon - Fri 8:00 to 5:00 (843) 234-8260 Gender: Female PCMH: No Fax: (843) 234-8224 Conway Medical Center Mon, Wed - Thu 8:00 to 5:00 300 Singleton Ridge Rd Cooper, Pansy APRN Tue 8:00 to 6:00 Conway, SC 29526-9142 Provider ID: 1849580 Fri 8:00 to 1:00 (843) 347-7111 Gender: Female PCMH: No Mon - Sun 12:00 to 12:00 Agape Senior Primary Care Inc DBA PCMH: No M Ditsious, Jaenell APRN 241 Singleton Ridge Rd, Unit B Provider ID: 1982019 Byrd, Mary APRN Conway, SC 29526-8371 Gender: Female Provider ID: 2318633 (843) 347-5661 Associated Medical Specialists Pa Gender: Female Fax: (843) 448-2691 817 Farrar Dr Cmc Primary Care Towne Center Mon - Fri 8:00 to 5:00 Conway, SC 29526-8747 5010 Carolina Forest Blvd PCMH: No (843) 234-1660 Myrtle Beach, SC 29579 Fax: (843) 234-1661 (843) 236-2700 Cowsar, Paul APRN Tue - Thu 8:00 to 4:30 Fax: (843) 236-2726 Provider ID: 1467814 Fri 8:00 to 3:00 Mon - Fri 8:00 to 5:00 Gender: Male PCMH: No PCMH: No South Crolina Primary Care Speciali 3501 Belle Terre Blvd, Ste A1 Ditsious, Jaenell APRN Calhoun, Amanda APRN Myrtle Beach, SC 29579 Provider ID: 2079155 Provider ID: 1990603 (843) 492-2790 Gender: Female Gender: Female Fax: (843) 353-2611 Cmc Cancer Center Cpg Pediatrics At Carolina Forest Mon - Fri 8:30 to 4:30 300 Singleton Ridge Rd 4022 Postal Way, Ste C PCMH: No Conway, SC 29526-9142 Myrtle Beach, SC 29579-3537 (843) 347-8050 (843) 903-4111 Fax: (843) 347-8049 Fax: (843) 903-4242 Mon - Fri 8:00 to 5:00 Mon - Thu 8:00 to 5:00 PCMH: No Fri 8:00 to 3:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 202 38642781

Allied Providers Horry Nurse Practitioner Family Medicine - Evans, Lauren APRN Flanegan, Renee APRN cont. Provider ID: 1789044 Provider ID: 1359822 Gender: Female Gender: Female Emerson, Jammie APRN Atlantic Urology Clinics LLC Atlantic Urology Clinics LLC Provider ID: 2171563 3617 Casey St, Ste B 823 82nd Pkwy Gender: Female Loris, SC 29569-2981 Myrtle Beach, SC 29572-4607 United Physician Group (843) 756-6319 (843) 449-1010 8203 Nigels Dr, Ste 100 Fax: (843) 756-5205 Fax: (843) 497-6171 Myrtle Beach, SC 29572-4177 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 (843) 491-1630 PCMH: No PCMH: No Fax: (843) 491-1634 Mon - Thu 8:00 to 5:00 Farley, Colleen APRN Floyd, Cassie APRN Fri 8:00 to 12:00 Provider ID: 1986039 Provider ID: 2208639 PCMH: No Gender: Female Gender: Female Associated Medical Specialists Pa Cmc Digestive Health Evans, Kerri APRN 8121 Rourk St 2376 Cypress Cir, Ste 203 Provider ID: 1556022 Myrtle Beach, SC 29572-4128 Conway, SC 29526-8994 Gender: Female (843) 692-5000 (843) 347-6038 Atlantic Urology Clinics LLC Fax: (843) 692-5010 Fax: (843) 347-9808 101 Mcleod Health Blvd, Ste 202 Mon - Thu 7:30 to 5:00 Mon - Thu 8:00 to 5:00 Myrtle Beach, SC 29579-4477 Fri 7:30 to 3:00 Fri 8:00 to 1:00 (843) 236-4949 Sat - Sun 9:00 to 12:00 PCMH: No Fax: (843) 236-4746 PCMH: No Mon - Fri 8:00 to 5:00 Freeman, Katherine APRN PCMH: No Ferguson, Naomi ARNP Provider ID: 1471496 Provider ID: 2168064 Evans, Kerri APRN Gender: Female Gender: Female Provider ID: 1556022 Roper St. Francis After Hours Care- Health Care Partners Of Sc Gender: Female 912 Inlet Square Drive, Ste A 1608 Main St Atlantic Urology Clinics LLC Murrells Inlet, SC 29576-7812 Conway, SC 29526-3572 3600 Sea Mountain Hwy, Ste D (843) 651-4111 (843) 488-6030 Little River, SC 29566-8161 Fax: (843) 651-1047 Fax: (877) 322-0181 (843) 390-8521 Mon - Fri 8:00 to 5:00 Mon - Fri 9:00 to 5:00 Fax: (843) 399-8932 PCMH: No Sat 8:00 to 12:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Flanegan, Renee APRN Provider ID: 1359822 Gallier, Catherine APRN Evans, Lauren APRN Gender: Female Provider ID: 2214990 Provider ID: 1789044 Atlantic Urology Clinics LLC Gender: Female Gender: Female 5046 Highway 17 Byp S, Ste 200 Palmetto Primary Care Physicians Atlantic Urology Clinics LLC Myrtle Beach, SC 29588-4503 912 Inlet Square Dr, Unit 206 3600 Sea Mountain Hwy, Ste B (843) 347-2450 Murrells Inlt, SC 29576-7812 Little River, SC 29566-8161 Fax: (843) 293-0448 (843) 651-4111 (843) 399-9696 Mon - Fri 8:00 to 5:00 Fax: (843) 492-4666 Fax: (843) 399-9596 PCMH: No Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 203 38642781

Allied Providers Horry Nurse Practitioner Family Medicine - Harding, Mary APRN Holmes, Regina APRN cont. Provider ID: 2158352 Provider ID: 1719962 Gender: Female Gender: Female Gardner, Carol APRN Sc House Calls Agape Senior Primary Care Inc Provider ID: 1224711 3600 Sea Mountain Hwy 3612 Mitchell St Gender: Female Little River, SC 29566-8161 Loris, SC 29569 Cpg Carolina Internal Medicine (843) 399-4848 (800) 491-0909 2367b Cypress Cir Fax: (843) 399-4409 Mon - Fri 8:00 to 5:00 Conway, SC 29526-8921 Mon - Fri 8:00 to 5:00 PCMH: No (843) 349-1001 PCMH: No Fax: (843) 349-1008 Hotaling, Ashleigh APRN Mon - Thu 8:30 to 5:00 Hewitt, Brenda APRN Provider ID: 2015641 Fri 8:30 to 1:00 Provider ID: 2348539 Gender: Female PCMH: No Gender: Female Mcleod Family Medicine Seacoast Cmc Primary Care Socastee 3980 Highway 9 E, Ste 100a Gibbs, Ashley APRN 6010 Highway 707 Little River, SC 29566-8163 Provider ID: 1323556 Myrtle Beach, SC 29588-7321 (843) 390-8320 Gender: Female (843) 293-1005 Fax: (843) 390-8329 Cpg Pediatrics Fax: (843) 293-1006 Mon - Fri 8:00 to 5:00 4022 Postal Way, Ste C Mon - Fri 8:00 to 4:30 PCMH: No Myrtle Beach, SC 29579-3537 Sat 8:00 to 12:00 (843) 903-4111 PCMH: No James, Paul APRN Fax: (843) 903-4242 Provider ID: 2101500 Mon - Fri 8:00 to 7:00 Hewitt, Brenda APRN Gender: Male Sat 8:00 to 12:00 Provider ID: 2361172 Mcleod Loris Primary Care PCMH: No Gender: Female 3109 Casey St Cmc Primary Care Postal Way Loris, SC 29569-2807 Hallock, Irene CNP 4022 Postal Way (843) 756-9292 Provider ID: 767964 Myrtle Beach, SC 29579-3537 Mon - Thu 7:00 to 5:00 Gender: Female (843) 236-0000 Fri 7:00 to 2:00 Forest Family Care Inc Fax: (843) 236-6191 PCMH: No 3874 Renee Dr, Ste B Mon - Fri 8:00 to 4:30 Myrtle Beach, SC 29579 Sat 8:00 to 12:00 Johnson, Nancy APRN (843) 903-4500 PCMH: No Provider ID: 2097733 Fax: (843) 903-4505 Gender: Female Mon - Fri 8:00 to 5:00 Hightower, Stephanie APRN Mcleod Family Medicine Carolina PCMH: No For Provider ID: 1983489 101 Mcleod Health Blvd, Ste 201 Hamilton, Cynthia APRN Gender: Female Myrtle Beach, SC 29579-4477 Provider ID: 1233341 Associated Medical Specialists Pa (843) 646-8001 Gender: Female 8121 Rourk St Fax: (843) 646-8002 Cmc Cardiac Care Myrtle Beach, SC 29572-4128 Mon - Fri 8:00 to 5:00 2376 Cypress Cir, Ste 102 (843) 692-5000 PCMH: No Conway, SC 29526-8964 Fax: (843) 692-5010 (843) 347-8953 Mon - Thu 7:30 to 5:00 Fax: (843) 347-0226 Fri 7:30 to 3:00 Mon - Fri 9:00 to 5:00 Sat - Sun 8:00 to 12:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 204 38642781

Allied Providers Horry Nurse Practitioner Family Medicine - Menser, Cheryl APRN Ruggerio, Joseph APRN cont. Provider ID: 2207426 Provider ID: 1845014 Gender: Female Gender: Male Kelly, Nanette APRN Cmc Endocrinology Grand Strand Specialty Associates Provider ID: 1989721 2376 Cypress Cir, Ste 202 8170 Rourk St, Ste 150 Gender: Female Conway, SC 29526 Myrtle Beach, SC 29572-4127 Associated Medical Specialists Pa (843) 234-9700 (843) 848-1440 3008 Bayboro St Fax: (843) 234-6896 Fax: (843) 353-3461 Loris, SC 29569-2714 Mon - Thu 8:30 to 5:00 Mon - Thu 8:00 to 5:00 (843) 756-0932 Fri 8:30 to 12:00 Fri 8:00 to 4:00 Fax: (843) 756-0508 PCMH: No PCMH: No Mon - Thu 8:00 to 4:30 Fri 8:00 to 3:00 Painter, Autumn APRN Schultz-Peters, Sandra APRN PCMH: No Provider ID: 2148094 Gender: Female Provider ID: 1822418 Lee, Jennifer APRN Health Care Partners Of Sc Inc. Gender: Female Provider ID: 1708471 1608 Main St Doctors Care Conway 501 Gender: Female Conway, SC 29526-3572 1113 Church St Cpg Family Medicine @ Towne (843) 488-6030 Conway, SC 29526-4128 Center Fax: (877) 322-0181 (843) 248-6269 5010 Carolina Forest Blvd Mon - Fri 8:00 to 5:00 Fax: (843) 248-0535 Myrtle Beach, SC 29579-3579 Sat 8:00 to 12:00 Mon - Sun 8:00 to 8:00 (843) 236-2700 PCMH: No PCMH: No Mon - Thu 8:00 to 7:00 Fri 8:00 to 5:00 Painter, Autumn APRN Smith, Tara APRN PCMH: No Provider ID: 2148094 Provider ID: 1837248 Gender: Female Gender: Female Matthews, Kara APRN Health Care Partners Of Sc Inc. Surfside Beach Urgent Care LLC Provider ID: 1834632 243 Singleton Ridge Rd, Units E F 1945 Glenns Bay Rd Gender: Female Conway, SC 29526 Surfside Beach, SC 29575-4833 Strand Gi Associates (843) 488-6030 (843) 650-4006 945 82nd Pkwy, Ste 3a Fax: (877) 322-0181 Fax: (843) 650-1418 Myrtle Beach, SC 29572-4612 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 8:00 (843) 449-3381 Sat 8:00 to 12:00 Sat - Sun 8:00 to 6:00 Fax: (843) 449-9721 PCMH: No PCMH: No Mon - Thu 8:00 to 5:00 Fri 8:00 to 1:00 Plowman, Lesley APRN Smith, Tara APRN PCMH: No Provider ID: 2402873 Provider ID: 1837249 Gender: Female Gender: Female Menser, Cheryl APRN Careteam Plus Inc Carolina Forest Urgent Care LLC Provider ID: 1963147 100 Professional Park Dr 185 Fresh Dr, Ste A Gender: Female Conway, SC 29526-9260 Myrtle Beach, SC 29579-4436 Doctors Care Conway 501 (843) 234-0005 (843) 945-3030 1113 Church St Fax: (843) 234-8224 Fax: (843) 492-4479 Conway, SC 29526-4128 Mon, Wed - Thu 8:00 to 5:00 Mon - Fri 8:00 to 8:00 (843) 248-6269 Tue 8:00 to 6:00 Sat - Sun 8:00 to 6:00 Fax: (843) 248-0535 Fri 8:00 to 1:00 PCMH: No Mon - Sun 8:00 to 8:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 205 38642781

Allied Providers Horry Nurse Practitioner Family Medicine - Steljes, Megan APRN Nurse Practitioner Womens Health cont. Provider ID: 1987249 Gender: Female Parker, Melinda APRN Smith, Justin CNP Associated Medical Specialists Pa Provider ID: 1557340 Provider ID: 2211155 817 Farrar Dr Gender: Female Gender: Male Conway, SC 29526-8747 Ohio Valley Physicians Inc Doctors Care Conway 501 (843) 234-1660 3471 Belle Terre Blvd, Ste A1 1113 Church St Fax: (843) 234-1661 Myrtle Beach, SC 29579-8405 Conway, SC 29526-4128 Mon - Thu 8:00 to 4:30 (843) 492-2790 (843) 248-6269 Fri 8:00 to 3:00 Fax: (843) 353-2611 Fax: (843) 248-0535 PCMH: No Mon - Fri 8:30 to 4:30 Mon - Sun 8:00 to 8:00 PCMH: No PCMH: No Whitehurst, Emily APRN Nutrition Soucy, Madeline APRN Provider ID: 2029277 Wiltshire, Charlotte RD Provider ID: 2160635 Gender: Female Provider ID: 1143423 Gender: Female Mcleod Cardiology Associates Gender: Female Sc House Calls Inc Myrtle Little River Medical Center Inc 3612 Mitchell St 107 Mcleod Health Blvd, Ste 202 3236 Holmestown Rd, Ste E1 Loris, SC 29569-2828 Myrtle Beach, SC 29579-4477 Myrtle Beach, SC 29588-7495 (843) 448-2228 (843) 839-1201 (843) 663-8000 Fax: (843) 448-2691 Fax: (843) 839-1202 Fax: (843) 663-8092 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Mon - Fri 8:30 to 5:30 PCMH: No PCMH: No PCMH: No

Stanley, Regina APRN Nurse Practitioner Pediatric Obstetrics/Gynecology Provider ID: 1829364 Gender: Female Bruce, Amanda APRN Harden, Sonya CNM Doctors Care Conway 501 Provider ID: 1990115 Provider ID: 1404667 1113 Church St Gender: Female Gender: Female Conway, SC 29526 Cmc Pediatrics-Conway Coastal Carolina OBGYN (843) 248-6269 2376 Cypress Cir, Ste 103 620 Singleton Ridge Rd Fax: (843) 248-0535 Conway, SC 29526-8964 Conway, SC 29526 Mon - Sun 8:00 to 8:00 (843) 234-8788 (843) 349-0100 PCMH: No Fax: (843) 234-8787 Mon - Fri 8:00 to 5:00 Fax: (843) 349-0104 Sat 8:00 to 12:00 Mon - Thu 9:00 to 5:00 States, Lindsey APRN PCMH: No Fri 9:00 to 12:00 Provider ID: 1969344 PCMH: No Gender: Female Doctos Care Pa Nurse Practitioner Psychiatric Miller, Ashley APRN 200 Middleburg Dr Mental Health Provider ID: 1222458 Myrtle Beach, SC 29579-3408 Gender: Female (843) 903-6650 Barnett, Andrietta APRN Tidelands Health Womens Center Fax: (843) 903-0758 Provider ID: 2306209 4320 Holmestown Rd Mon - Fri 8:00 to 8:00 Gender: Female Myrtle Beach, SC 29588-7837 Sat - Sun 9:00 to 5:00 Sandhills Intergrated Care Inc (843) 652-8220 PCMH: No 3993 Meeting St Loris, SC 29569-3053 Fax: (843) 652-0127 (843) 756-3008 Mon - Fri 9:00 to 5:00 Fax: (843) 756-3128 PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 206 38642781

Allied Providers Horry Occupational Therapy Brunson, Monica OT Farnill, Leslie OT Provider ID: 1829946 Provider ID: 1851898 Apple, Claire OT Gender: Female Gender: Female Provider ID: 771557 Therapy Consortium Inc Therapy Consortium Inc Gender: Female 4761 Highway 501, Ste 1 4761 Highway 501, Ste 1 Myrtle Beach Physical Therapy Myrtle Beach, SC 29579-9457 Myrtle Beach, SC 29579-9457 4237 River Hills Dr, Ste 120 (843) 455-7505 (843) 455-7505 Little River, SC 29566 Fax: (866) 457-1014 Mon - Fri 8:00 to 6:00 (843) 249-5616 Mon - Fri 8:00 to 6:00 PCMH: No Fax: (843) 249-1843 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Hafenbreidel, Jill OT Dieter, Sara PT Provider ID: 2116662 Provider ID: 775122 Gender: Female Arthur, Rachel OT Gender: Female Therapy Consortium Inc Provider ID: 2190542 Myrtle Beach Physical Therapy 4761 Highway 501, Ste 1 Gender: Female 4237 River Hills Dr, Ste 120 Myrtle Beach, SC 29579 Therapy Consortium Inc. Little River, SC 29566 (843) 236-9751 4761 Highway 501 (843) 249-5616 Fax: (866) 571-1014 Myrtle Beach, SC 29579-9457 Fax: (843) 249-1843 Mon - Fri 8:00 to 6:00 (843) 236-9751 Mon - Fri 8:00 to 5:00 PCMH: No Fax: (866) 571-1014 PCMH: No Mon - Fri 8:00 to 6:00 PCMH: No Hardee, Katherine OT Dixon, Heather OT Provider ID: 1723306 Provider ID: 2266852 Gender: Female Brown, Regina OT Gender: Female Therapy Consortium Inc. Provider ID: 1645548 Therapy Consortium Inc 4761 Highway 501, Ste 1 Gender: Female 4761 Highway 501, Ste 1 Myrtle Beach, SC 29579-9457 All About Therapy LLC Myrtle Beach, SC 29579-9457 (843) 236-9751 5046 Hwy 17 Byp S, Ste 205 (888) 510-6369 Fax: (866) 571-5014 Myrtle Beach, SC 29588-4503 Fax: (866) 571-1014 Mon - Fri 8:00 to 6:00 (843) 748-0707 Mon - Fri 7:30 to 6:30 PCMH: No Fax: (843) 748-0751 PCMH: No Mon - Thu 8:00 to 5:00 Fri 8:00 to 12:00 Krauss, Kari OT PCMH: No Doherty, Meghan OT Provider ID: 771856 Provider ID: 1993026 Gender: Female Gender: Female Therapy Consortium Inc Brown, Katherine OT Therapy Consortium Inc 4761 Highway 501, Ste 1 Provider ID: 773325 4761 Hwy 501, Ste 1 Myrtle Beach, SC 29579-9457 Gender: Female Myrtle Beach, SC 29579-9457 (843) 455-7505 Childrens Therapy Services Inc (843) 455-7505 Fax: (866) 571-1014 5069 Spanish Oaks Ct Fax: (866) 571-1014 Mon - Fri 9:00 to 5:00 Murrells Inlet, SC 29576-5448 Mon - Fri 8:00 to 5:00 PCMH: No (843) 357-6797 PCMH: No Fax: (843) 357-6935 Mon - Fri 9:00 to 5:00 PCMH: No Egan, Brad OT Provider ID: 1580904 Gender: Male Therapy Consortium Inc 4761 Highway 501, Ste 1 Myrtle Beach, SC 29579-9457 (843) 236-9751 Mon - Fri 8:00 to 6:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 207 38642781

Allied Providers Horry Occupational Therapy - cont. Mims, Teresa OT Tardy, Paul OT Provider ID: 1239533 Provider ID: 1433911 Lewis, Katie OT Gender: Female Gender: Male Provider ID: 1023527 Herapy Consortium Therapy Consortium Inc. Gender: Female 4761 Highway 501, Ste #1 4761 Highway 501, Ste 1 Doyle Nobles Fundamentals Pedi- Myrtle Beach, SC 29579 Myrtle Beach, SC 29579-9457 atric (843) 455-7505 (843) 455-7505 2540b Highway 501 E Fax: (866) 571-1014 Mon - Fri 9:00 to 6:30 Aynor, SC 29511-3477 Mon - Fri 9:00 to 6:30 PCMH: No (843) 358-1457 PCMH: No Fax: (843) 358-1458 Mon, Wed 8:00 to 5:00 Torosian, Valeriya OT Tue, Thu 8:00 to 6:00 Monday, Michelle OT Provider ID: 916389 PCMH: No Provider ID: 774113 Gender: Female Gender: Female Therapy Consortium Inc Myrtle Beach Physical Therapy 4761 Highway 501, Ste 1 Merritt, Rhonda OT 210 Vlg Ctr Blvd, Ste 100 Myrtle Beach, SC 29579-9457 Provider ID: 772228 Myrtle Beach, SC 29578-6706 (843) 455-7505 Gender: Female (843) 491-4937 Fax: (866) 571-1014 Hand Therapy Plus Fax: (843) 491-4938 Mon - Fri 9:00 to 6:30 1200 48th Ave N Mon - Fri 9:00 to 5:00 PCMH: No Myrtle Beach, SC 29577 PCMH: No (843) 497-0201 Fax: (843) 497-0195 Vermillion, Krystal OT Mon - Fri 8:00 to 5:00 Prock, Kelly OT Provider ID: 2385974 PCMH: No Provider ID: 1640137 Gender: Female Gender: Female Therapy Consortium Inc Therapy Consortium Inc 4761 Highway 501, Ste 1 Merritt, Rhonda OT 4761 Highway 501, Ste 1 Myrtle Beach, SC 29579-9457 Provider ID: 772228 Myrtle Beach, SC 29579-9457 (843) 455-7505 Gender: Female (843) 236-9751 Fax: (866) 571-1014 Myrtle Beach Physical Therapy Fax: (866) 571-1014 Mon - Fri 8:00 to 6:00 210 Vlg Ctr Blvd, Ste 100 Mon - Fri 8:00 to 6:00 PCMH: No Myrtle Beach, SC 29579 PCMH: No (843) 491-4937 Fax: (843) 491-4938 Williams, Taylor OT Mon - Fri 8:00 to 5:00 Roberts, Juliet OT Provider ID: 2297063 PCMH: No Provider ID: 1835727 Gender: Female Gender: Female Therapy Consortium Inc. Therapy Consortium Inc. 4761 Highway 501, Ste 1 Merritt, Rhonda OT 4761 Highway 501, Ste 1 Myrtle Beach, SC 29579-9457 Provider ID: 772228 Myrtle Beach, SC 29579-9457 (843) 455-7505 Gender: Female (843) 236-9751 Fax: (866) 571-1014 Myrtle Beach Physical Therapy Fax: (866) 571-1014 Mon - Fri 8:00 to 6:00 4237 River Hills Dr, Ste 120 Mon - Fri 8:00 to 6:00 PCMH: No Little River, SC 29566 PCMH: No (843) 249-5616 Fax: (843) 249-1843 Mon - Fri 8:00 to 5:00 Stull, Ashley OT PCMH: No Provider ID: 1274089 Gender: Female Therapy Consortium Inc 4761 Highway 501, Ste 1 Myrtle Beach, SC 29579 (843) 236-9751 Fax: (866) 571-1014 Mon - Fri 9:00 to 6:30 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 208 38642781

Allied Providers Horry Pediatrics Bouchard, Kristen PT Brazill, Brittany PT Provider ID: 776109 Provider ID: 1544665 Pelinka, Sarah APRN Gender: Female Gender: Female Provider ID: 2201417 Myrtle Beach Physical Therapy Ati Physical Therapy Of Greenville Gender: Female 4237 River Hills Dr, Ste 120 4237 River Hills Dr, Ste 110 Mcleod Health Loris Seacoast Little River, SC 29566 Little River, SC 29566-6444 3655 Mitchell St (843) 249-5616 (843) 999-0900 Loris, SC 29569-2827 Fax: (843) 249-1843 Fax: (843) 491-2040 (843) 777-5240 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 777-5572 PCMH: No PCMH: No Mon - Sun 12:00 to 12:00 PCMH: No Bowen, Cary PT Brazill, Brittany PT Provider ID: 771611 Provider ID: 1544665 Physical Therapy Gender: Male Gender: Female Altena, Kristine PT Myrtle Beach Physical Therapy Ati Physical Therapy Of Greenville Provider ID: 777122 4237 River Hills Dr, Ste 120 8161 Rourk St Gender: Female Little River, SC 29566 Myrtle Beach, SC 29572-4128 Myrtle Beach Physical Therapy (843) 249-5616 (843) 449-3685 4237 River Hills Dr, Ste 120 Fax: (843) 249-1843 Fax: (843) 449-2746 Little River, SC 29566 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 (843) 249-5616 PCMH: No PCMH: No Fax: (843) 249-1843 Mon - Fri 9:00 to 5:00 Brangers, Jennifer PT Brazill, Brittany PT PCMH: No Provider ID: 777276 Provider ID: 1544665 Gender: Female Gender: Female Bolton, Paula PT Myrtle Beach Physical Therapy Ati Physical Therapy Of Greenville Provider ID: 775713 210 Villiage Blvd, Ste 100 210 Village Center Blvd, Ste 100 Gender: Female Myrtle Beach, SC 29579 Myrtle Beach, SC 29579-6706 Myrtle Beach Physical Therapy (843) 491-4937 (843) 491-4944 4237 River Hills Dr, Ste 120 Fax: (843) 491-4938 Fax: (843) 494-4938 Little River, SC 29566 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 (843) 249-5616 PCMH: No PCMH: No Fax: (843) 249-1843 Mon - Fri 8:00 to 5:00 Brangers, Jennifer PT Brazill, Brittany PT PCMH: No Provider ID: 777276 Provider ID: 1544665 Gender: Female Gender: Female Bondi, Evelyn PT Myrtle Beach Physical Therapy Ati Physical Therapy Of Greenville Provider ID: 2400898 4237 River Hills Dr, Ste 120 4237 River Hills Dr, Ste 120 Gender: Female Little River, SC 29566 Little River, SC 29566-6444 Ati Physical Therapy Of Greenville (843) 249-5616 (843) 249-5616 8161 Rourk St Fax: (843) 249-1843 Fax: (843) 249-1843 Myrtle Beach, SC 29572-4128 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 (843) 449-3685 PCMH: No PCMH: No Fax: (843) 449-2746 Mon - Fri 8:00 to 5:00 Brangers, Jennifer PT Breeden, Melissa PT PCMH: No Provider ID: 777276 Provider ID: 772433 Gender: Female Gender: Female Strand Therapy Strand Therapy 8161 Rourk St 8161 Rourk St Myrtle Beach, SC 29572 Myrtle Beach, SC 29572 (843) 449-3685 (843) 449-3685 Fax: (843) 449-2746 Fax: (843) 449-2746 Mon - Fri 8:00 to 5:00 Mon - Fri 9:00 to 5:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 209 38642781

Allied Providers Horry Physical Therapy - cont. Cheng, Vicki PT Cole, James PT Provider ID: 775931 Provider ID: 776953 Burkert, Stephen PT Gender: Female Gender: Male Provider ID: 772155 Myrtle Beach Physical Therapy Myrtle Beach Physical Therapy Gender: Male 4237 River Hills Dr, Ste 120 4237 River Hills Dr, Ste 120 Myrtle Beach Physical Therapy Little River, SC 29566 Little River, SC 29566 4237 River Hills Dr, Ste 120 (843) 249-5616 (843) 249-5616 Little River, SC 29566 Fax: (843) 249-1843 Fax: (843) 249-1843 (843) 249-5616 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 249-1843 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Chiarmonte, Anthony PT Congdon, Karyn PT Provider ID: 2280910 Provider ID: 1543339 Burkert, Stephen PT Gender: Male Gender: Female Provider ID: 772155 Ati Physical Therapy Of Greenville Therapy Consortium Gender: Male 29 N Academy St, Ste 120 4761 Highway 501, Ste 1 Strand Therapy Little River, SC 29566-6444 Myrtle Beach, SC 29579-9457 8161 Rourk St (843) 249-5616 (843) 455-7505 Myrtle Beach, SC 29572 Fax: (843) 249-1843 Fax: (843) 571-1014 (843) 449-3685 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 6:00 Fax: (843) 449-2746 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Chitty, Nina PT Cooperman, Tyler PT Provider ID: 770397 Provider ID: 2400894 Charles, Gabrielle PT Gender: Female Gender: Male Provider ID: 2150638 Myrtle Beach Physical Therapy Ati Physical Therapy Of Greenville Gender: Female 4237 River Hills Dr, Ste 120 4237 River Hills Dr, Ste 120 Ati Physical Therapy Of Greenville Little River, SC 29566 Little River, SC 29566-6444 4237 River Hills Dr, Ste 110 (843) 249-5616 (843) 249-5616 Little River, SC 29566-6444 Fax: (843) 249-1843 Fax: (843) 249-1843 (843) 999-0900 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 491-2040 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Christiansen, Laura PT Cumbie, Heather PT Provider ID: 775499 Provider ID: 771872 Charles, Gabrielle PT Gender: Female Gender: Female Provider ID: 2150638 Myrtle Beach Physical Therapy Myrtle Beach Physical Therapy Gender: Female 4237 River Hills Dr, Ste 120 4237 River Hills Dr, Ste 120 Ati Physical Therapy Of Greenville Little River, SC 29566 Little River, SC 29566 4237 River Hills Dr, Ste 120 (843) 249-5616 (843) 249-5616 Little River, SC 29566-6444 Fax: (843) 249-1843 Fax: (843) 249-1843 (843) 249-5616 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 249-1843 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Cole, James PT Demarco, Donna PT Provider ID: 776953 Provider ID: 1436745 Gender: Male Gender: Female Myrtle Beach Physical Therapy Therapy Consortium Inc 210 Village Blvd, Ste 100 4761 Highway 501, Ste 1 Myrtle Beach, SC 29579 Myrtle Beach, SC 29579 (843) 491-4937 (843) 455-7505 Fax: (843) 491-4938 Fax: (866) 571-1014 Mon - Fri 8:00 to 5:00 Mon - Fri 9:00 to 6:30 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 210 38642781

Allied Providers Horry Physical Therapy - cont. Dukes, Laura PT Fontanares, Roland PT Provider ID: 776129 Provider ID: 770337 Destefano, Ellen PT Gender: Female Gender: Male Provider ID: 1709686 Strand Therapy Myrtle Beach Physical Therapy Gender: Female 8161 Rourk St 4237 River Hills Dr, Ste 120 Ati Physical Therapy Of Greenville Myrtle Beach, SC 29572 Little River, SC 29566 5046 Highway 17 Byp S, Ste 201 (843) 449-3685 (843) 249-5616 Myrtle Beach, SC 29588-4503 Fax: (843) 449-2746 Fax: (843) 249-1843 (630) 296-2222 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (630) 759-9510 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Durst, Kimberly PT Fontanares, Roland PT Provider ID: 775240 Provider ID: 770337 Dorton, Kathy PT Gender: Female Gender: Male Provider ID: 770332 Myrtle Beach Physical Therapy Strand Therapy Gender: Female 4237 River Hills Dr, Ste 120 8161 Rourk St Therapy Consortium Inc Little River, SC 29566 Myrtle Beach, SC 29572 4761 Highway 501, Ste 1 (843) 249-5616 (843) 449-3685 Myrtle Beach, SC 29579-9457 Fax: (843) 249-1843 Fax: (843) 449-2746 (843) 455-7505 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 571-1014 PCMH: No PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No Ferranti, Vincenzo PT Foster, Karen PT Provider ID: 1830077 Provider ID: 1641492 Dukes, Laura PT Gender: Male Gender: Female Provider ID: 776129 Ati Physical Therapy Of Greenville Therapy Consortium Gender: Female 4237 River Hills Dr, Suite 120 4761 Hwy 501, Ste 1 Myrtle Beach Physical Therapy Little River, SC 29566-6444 Myrtle Beach, SC 29579-9457 210 Villiage Blvd, Ste 100 (843) 249-5616 (843) 455-7505 Myrtle Beach, SC 29579 Fax: (843) 249-1843 Fax: (866) 571-1014 (843) 491-4937 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 6:30 Fax: (843) 491-4938 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Fitzgerald, John PT Gibson, Elizabeth PT Provider ID: 775670 Provider ID: 1465973 Dukes, Laura PT Gender: Male Gender: Female Provider ID: 776129 Myrtle Beach Physical Therapy Low Country Physical Theapy Gender: Female 4237 River Hills Dr, Ste 120 2586 Hwy 17 Business S Myrtle Beach Physical Therapy Little River, SC 29566 Murrells Inlet, SC 29576 4237 River Hills Dr, Ste 120 (843) 249-5616 (843) 651-6565 Little River, SC 29566 Fax: (843) 249-1843 Fax: (843) 651-6575 (843) 249-5616 Mon - Sat 8:00 to 5:00 Mon - Thu 7:30 to 6:00 Fax: (843) 249-1843 PCMH: No Fri 7:30 to 1:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No Fontanares, Roland PT Provider ID: 770337 Gender: Male Myrtle Beach Physical Therapy 210 Villiage Blvd, Ste 100 Myrtle Beach, SC 29579 (843) 491-4937 Fax: (843) 491-4938 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 211 38642781

Allied Providers Horry Physical Therapy - cont. Heniford, Mary PT Hershberger, Corey PT Provider ID: 771445 Provider ID: 1340242 Graham, Megan PT Gender: Female Gender: Female Provider ID: 774411 Myrtle Beach Physical Therapy Ati Physical Therapy Of Greenville Gender: Female 210 Villiage Blvd, Ste 100 8161 Rourk St Myrtle Beach Physical Therapy Myrtle Beach, SC 29579 Myrtle Beach, SC 29572-4128 4237 River Hills Dr, Ste 120 (843) 491-4937 (843) 449-3685 Little River, SC 29566 Fax: (843) 491-4938 Fax: (843) 449-2746 (843) 249-5616 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 249-1843 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Heniford, Mary PT Hite, Stephanie PT Provider ID: 771445 Provider ID: 1709754 Grant, Lisa PT Gender: Female Gender: Female Provider ID: 772140 Myrtle Beach Physical Therapy Ati Physical Therapy Of Greenville Gender: Female 4237 River Hills Dr, Ste 120 3545 Highway 17, Unit 250 Myrtle Beach Physical Therapy Little River, SC 29566 Murrells Inlet, SC 29576-5114 4237 River Hills Dr, Ste 120 (843) 249-5616 (843) 299-1721 Little River, SC 29566 Fax: (843) 249-1843 Fax: (843) 299-1720 (843) 249-5616 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 249-1843 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Heniford, Mary PT Hite, Stephanie PT Provider ID: 771445 Provider ID: 1709754 Hauberg, Julie PT Gender: Female Gender: Female Provider ID: 1778680 Strand Therapy Ati Physical Therapy Of Greenville Gender: Female 8161 Rourk St 5046 Highway 17 Byp S, Ste 201 Ati Physical Therapy Of Greenville Myrtle Beach, SC 29572 Myrtle Beach, SC 29588-4503 4237 River Hills Dr, Suite 110 (843) 449-3685 (630) 296-2222 Little River, SC 29566-6444 Fax: (843) 449-2746 Fax: (630) 759-9510 (843) 999-0900 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 491-2040 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Hershberger, Corey PT Hite, Stephanie PT Provider ID: 1340242 Provider ID: 1709754 Heilman, D'andra. PT Gender: Female Gender: Female Provider ID: 770198 Ati Physical Therapy Of Greenville Ati Physical Therapy Of Greenville Gender: Female 210 Vlg Ctr Blvd, Ste 100 8161 Rourk St Clemson Sports Medicine Inc Myrtle Beach, SC 29579-6706 Myrtle Beach, SC 29572-4128 4237 River Hills Dr, Ste 120 (843) 491-4944 (843) 449-3685 Little River, SC 29566 Fax: (843) 494-4938 Fax: (843) 449-2746 (843) 249-5616 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 249-1843 PCMH: No PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No Hershberger, Corey PT Hyer, Eric PT Provider ID: 1340242 Provider ID: 776378 Gender: Female Gender: Male Ati Physical Therapy Of Greenville Myrtle Beach Physical Therapy 4237 River Hills Dr, Ste 110 210 Village Blvd, Ste 100 Little River, SC 29566-6444 Myrtle Beach, SC 29579 (843) 999-0900 (843) 491-4937 Fax: (843) 491-2040 Fax: (843) 491-4938 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 212 38642781

Allied Providers Horry Physical Therapy - cont. Jennings, Jennifer PT Kaminski, Daniel PT Provider ID: 776803 Provider ID: 2136191 Hyer, Eric PT Gender: Female Gender: Male Provider ID: 776378 Therapy Consortium Inc Ati Physical Therapy Of Greenville Gender: Male 4761 Highway 501, Ste 1 8161 Rourk St Myrtle Beach Physical Therapy Myrtle Beach, SC 29579-9457 Myrtle Beach, SC 29572-4128 4237 River Hills Dr, Ste 120 (843) 455-7505 (843) 449-3685 Little River, SC 29566 Fax: (866) 571-1014 Fax: (843) 449-2746 (843) 249-5616 Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 249-1843 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Jennings, Jennifer PT Kline, Daniel PT Provider ID: 776804 Provider ID: 1450690 Ittenbach, Dennis PT Gender: Female Gender: Male Provider ID: 773903 Childrens Therapy Specialists Ati Physical Therapy Of Greenville Gender: Male 5069 Spanish Oaks Ct 210 Village Center Blvd, Ste 100 Myrtle Beach Physical Therapy Murrells Inlet, SC 29576 Myrtle Beach, SC 29579-6706 210 Villiage Blvd, Ste 100 (843) 222-0564 (843) 491-4944 Myrtle Beach, SC 29579 Fax: (843) 357-6935 Fax: (843) 494-4938 (843) 491-4937 Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 491-4938 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Kaminski, Daniel PT Kline, Daniel PT Provider ID: 2136191 Provider ID: 1450690 Ittenbach, Dennis PT Gender: Male Gender: Male Provider ID: 773903 Ati Physical Therapy Of Greenville Ati Physical Therapy Of Greenville Gender: Male 4237 River Hills Dr, Ste 110 8161 Rourk St Myrtle Beach Physical Therapy Little River, SC 29566-6444 Myrtle Beach, SC 29572-4128 4237 River Hills Dr, Ste 120 (843) 999-0900 (843) 449-3685 Little River, SC 29566 Fax: (630) 759-9510 Fax: (843) 449-2746 (843) 249-5616 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 249-1843 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Kaminski, Daniel PT Kunz, Rachel PT Provider ID: 2136191 Provider ID: 1224714 Ittenbach, Dennis PT Gender: Male Gender: Female Provider ID: 773903 Ati Physical Therapy Of Greenville Therapy Consortium Inc. Gender: Male 4237 River Hills Dr, Ste 120 4761 Highway 501, Ste 1 Strand Therapy Little River, SC 29566-6444 Myrtle Beach, SC 29579 8161 Rourk St (843) 249-5616 (843) 455-7505 Myrtle Beach, SC 29572 Fax: (843) 249-1843 Fax: (866) 571-1014 (843) 449-3685 Mon - Fri 8:00 to 5:00 Mon - Fri 9:00 to 6:30 Fax: (843) 449-2746 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Kaminski, Daniel PT Laspada, Raymond PT Provider ID: 2136191 Provider ID: 1984760 Gender: Male Gender: Male Ati Physical Therapy Of Greenville Pediatric Consultin 5046 Highway 17 Byp S, Ste 201 2922 Howard Ave, Unit D Myrtle Beach, SC 29588-4503 Myrtle Beach, SC 29577-1901 (630) 296-2222 (843) 236-9751 Fax: (630) 759-9510 Fax: (866) 571-1014 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 6:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 213 38642781

Allied Providers Horry Physical Therapy - cont. Montenery, Jason PT Patton, Melissa PT Provider ID: 1465451 Provider ID: 1432185 Lee, Matthew PT Gender: Male Gender: Female Provider ID: 776064 Low Country Physical Therapy Inc Low Country Physical Therapy Gender: Male 2586 Highway 17 Business S 2586 Highway 17 Business South Myrtle Beach Physical Therapy Murrells Inlet, SC 29576 Murrells Inlet, SC 29576 4237 River Hills Dr, Ste 120 (843) 651-6565 (843) 651-6565 Little River, SC 29566 Fax: (843) 651-6575 Fax: (843) 651-6575 (843) 249-5616 Mon - Thu 7:30 to 6:00 Mon - Thu 7:30 to 6:00 Fax: (843) 249-1843 Fri 7:30 to 1:00 Fri 7:30 to 1:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No Orlando, Erik PT Pecylak, Colleen PT Lynch, Nancy PT Provider ID: 1778633 Provider ID: 2186278 Provider ID: 2359948 Gender: Male Gender: Female Gender: Female Ati Physical Therapy Of Greenville Therapy Consortium Inc Therapy Consortium Inc 3545 Highway 17 Bypass, Suite 250 4761 Highway 501, Ste 1 4761 Highway 501, Ste 1 Murrells Inlet, SC 29576-5114 Myrtle Beach, SC 29579-9457 Myrtle Beach, SC 29579-9457 (843) 299-1721 (843) 455-7565 (843) 236-9751 Fax: (843) 299-1720 Fax: (866) 571-1014 Fax: (866) 571-1014 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 6:00 Mon - Fri 8:00 to 6:00 PCMH: No PCMH: No PCMH: No Orlando, Erik PT Phillips, Kristopher PT Mace, Alexandra PT Provider ID: 1778633 Provider ID: 771372 Provider ID: 1778705 Gender: Male Gender: Male Gender: Female Ati Physical Therapy Of Greenville Myrtle Beach Physical Therapy Ati Physical Therapy Of Greenville 4237 River Hills Dr, Suite 110 4237 River Hills Dr, Ste 120 210 Village Center Blvd, Suite 100 Little River, SC 29566-6444 Little River, SC 29566 Myrtle Beach, SC 29579-6706 (843) 999-0900 (843) 249-5616 (843) 491-4944 Fax: (843) 491-2040 Fax: (843) 249-1843 Fax: (843) 494-4938 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No Parker, Stephen MD Porada, Theodore PT Meseck, Michael PT Provider ID: 772169 Provider ID: 771644 Provider ID: 773191 Gender: Male Gender: Male Gender: Male Carolina Orthopedic Specialists LLC Myrtle Beach Physical Therapy Nort Myrtle Beach Physical Therapy 3515 Caduceus Dr 4237 River Hills Dr, Ste 120 4237 River Hills Dr, Ste 120 Myrtle Beach, SC 29588 Little River, SC 29566 Little River, SC 29566 (843) 294-1941 (843) 249-5616 (843) 249-5616 Fax: (843) 294-1945 Fax: (843) 249-1843 Fax: (843) 249-1843 Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 214 38642781

Allied Providers Horry Physical Therapy - cont. Sherrill, Phillip PT Sullivan, Nekita PT Provider ID: 1778652 Provider ID: 1340288 Priganc, Tammy PT Gender: Male Gender: Female Provider ID: 772197 Ati Physical Therapy Of Greenville Ati Physical Therapy Of Greenville Gender: Female 4237 River Hills Dr, Ste 120 4237 River Hills Dr, Ste 110 Therapy Consortium Inc Little River, SC 29566-6444 Little River, SC 29566-6444 4761 Highway 501, Ste 1 (843) 249-5616 (843) 999-0900 Myrtle Beach, SC 29579-9457 Fax: (864) 249-1843 Fax: (843) 491-2040 (843) 455-7505 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (866) 571-1014 PCMH: No PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No Sherrill, Phillip PT Sullivan, Nekita PT Provider ID: 1778652 Provider ID: 1340288 Rockwell, Mason PT Gender: Male Gender: Female Provider ID: 2400803 Ati Physical Therapy Of Greenville Ati Physical Therapy Of Greenville Gender: Male 8161 Rourk St 8161 Rourk St Ati Physical Therapy Of Greenville Myrtle Beach, SC 29572-4128 Myrtle Beach, SC 29572-4128 8161 Rourk St (843) 449-3685 (843) 449-3685 Myrtle Beach, SC 29572-4128 Fax: (843) 449-2746 Fax: (843) 449-2746 (843) 449-3685 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 449-2746 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Singh, Githa PT Todd, Molly PT Provider ID: 927913 Provider ID: 1709726 Schneider, Nicole PT Gender: Female Gender: Female Provider ID: 775911 Therapy Consortium Inc Ati Physical Therapy Of Greenville Gender: Female 4761 Highway 501, Ste 1 3545 Highway 17, Unit 250 Myrtle Beach Physical Therapy Myrtle Beach, SC 29579-9457 Murrells Inlet, SC 29576-5114 4237 River Hills Dr, Ste 120 (843) 455-7505 (843) 299-1721 Little River, SC 29566 Fax: (866) 571-1014 Fax: (843) 299-1720 (843) 249-5616 Mon - Fri 9:00 to 6:30 Mon - Fri 8:00 to 5:00 Fax: (843) 249-1843 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Stoker, James PT Turner, Allison PT Provider ID: 774396 Provider ID: 774317 Sherrill, Phillip PT Gender: Male Gender: Female Provider ID: 1778652 Myrtle Beach Physical Therapy Myrtle Beach Physical Therapy Gender: Male 4237 River Hills Dr, Ste 120 4237 River Hills Dr, Ste 120 Ati Physical Therapy Of Greenville Little River, SC 29566 Little River, SC 29566 4237 River Hills Dr, Ste 110 (843) 249-5616 (843) 249-5616 Little River, SC 29566-6444 Fax: (843) 249-1843 Fax: (843) 249-1843 (843) 999-0900 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Fax: (843) 491-2040 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Sullivan, Nekita PT Twaddle, Carianna PT Provider ID: 1340288 Provider ID: 773234 Gender: Female Gender: Female Ati Physical Therapy Of Greenville Myrtle Beach Physical Therapy 210 Vlg Ctr Blvd, Ste 100 210 Villiage Blvd, Ste 100 Myrtle Beach, SC 29579-6706 Myrtle Beach, SC 29579 (843) 491-4944 (843) 491-4937 Fax: (843) 494-4938 Fax: (843) 491-4938 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 215 38642781

Allied Providers Horry Physical Therapy - cont. Welch, Erin PT Physician Assistant Provider ID: 773487 Twaddle, Carianna PT Gender: Female Alsworth, Roberta PA Provider ID: 773234 Hand Therapy Plus Provider ID: 1316945 Gender: Female 1200 48th Ave N Gender: Female Strand Therapy Myrtle Beach, SC 29577 Mcleod Vascular Associates 8161 Rourk St (843) 236-6767 Seacoast Myrtle Beach, SC 29572 Fax: (843) 236-6771 3617 Casey St, Ste C (843) 449-3685 Mon - Fri 8:00 to 5:00 Loris, SC 29569-2981 Fax: (843) 449-2746 PCMH: No (843) 716-8940 Mon - Fri 8:00 to 5:00 Fax: (843) 716-9760 PCMH: No Mon - Fri 8:00 to 5:00 Welch, Erin PT PCMH: No Provider ID: 773487 Vance, Darren PT Gender: Female Provider ID: 775251 Myrtle Beach Physical Therapy Alsworth, Roberta PA Gender: Male 210 Villiage Blvd, Ste 100 Provider ID: 1316945 Myrtle Beach Physical Therapy Myrtle Beach, SC 29579 Gender: Female 210 Villiage Blvd, Ste 100 (843) 491-4937 Mcleod Cardiology Associates Myrtle Beach, SC 29579 Fax: (843) 491-4938 Myrtle (843) 491-4937 Mon - Fri 8:00 to 5:00 107 Mcleod Health Blvd, Ste 202 Fax: (843) 491-4938 PCMH: No Myrtle Beach, SC 29579-4477 Mon - Fri 8:00 to 5:00 (843) 839-1201 PCMH: No Fax: (843) 839-1202 Welch, Erin PT Mon - Thu 8:00 to 5:00 Provider ID: 773487 Vance, Darren PT Fri 8:00 to 1:00 Gender: Female PCMH: No Provider ID: 775251 Myrtle Beach Physical Therapy Gender: Male 4237 River Hills Dr, Ste 120 Myrtle Beach Physical Therapy Little River, SC 29566 Bethle, Joseph PA 4237 River Hills Dr, Ste 120 (843) 249-5616 Provider ID: 1783549 Little River, SC 29566 Fax: (843) 249-1843 Gender: Male (843) 249-5616 Mon - Fri 8:00 to 5:00 Grand Strand Specialty Associates Fax: (843) 249-1843 PCMH: No 849 82nd Pkwy Mon - Fri 8:00 to 5:00 Myrtle Beach, SC 29572-4614 PCMH: No (843) 449-2336 White, Amie Kaye PT Fax: (849) 497-0625 Provider ID: 772813 Vance, Darren PT Mon - Fri 8:00 to 5:00 Gender: Female PCMH: No Provider ID: 775251 Myrtle Beach Physical Therapy Gender: Male 4237 River Hills Dr, Ste 120 Strand Therapy Little River, SC 29566 Bethle, Joseph PA 8161 Rourk St (843) 249-5616 Provider ID: 2287653 Myrtle Beach, SC 29572 Fax: (843) 249-1843 Gender: Male (843) 449-3685 Mon - Fri 8:00 to 5:00 Grand Strand Orthopedic Care Fax: (843) 449-2746 PCMH: No 920 Doug White Dr, Ste 130 Mon - Fri 8:00 to 5:00 Myrtle Beach, SC 29572-4180 PCMH: No (843) 497-6348 Fax: (843) 497-6351 Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 216 38642781

Allied Providers Horry Physician Assistant - cont. Finley, Erin PA Gardache, Marissa PA Provider ID: 1281097 Provider ID: 1855483 Blanton, Adam PA Gender: Female Gender: Female Provider ID: 1476766 Coastal Carolina Otolaryngology Grand Strand Specialty Associates Gender: Male Ass 849 82nd Pkwy Ohio Valley Physicians Inc 1021 Cipriana Dr, Ste 220 Myrtle Beach, SC 29572-4614 3501 Belle Terre Blvd, Ste A1 Myrtle Beach, SC 29572 (843) 449-2336 Myrtle Beach, SC 29579 (843) 449-6449 Fax: (843) 497-0625 (843) 492-2790 Fax: (843) 449-1069 Mon - Thu 8:00 to 5:00 Fax: (843) 353-2611 Mon - Fri 8:00 to 5:00 Fri 8:00 to 4:00 Mon - Fri 9:00 to 5:00 PCMH: No PCMH: No PCMH: No Floyd, Erin PA Hancock, Amy PA Britton, Kallie PA Provider ID: 1640126 Provider ID: 2171539 Provider ID: 1913474 Gender: Female Gender: Female Gender: Female Sc House Calls Inc United Physicians Group Cmc Cardiac Care 3600 Sea Mountain Hwy, Ste C 8203 Nigels Dr, Ste 100 2376 Cypress Cir, Ste 102 Little River, SC 29566-8161 Myrtle Beach, SC 29572-4177 Conway, SC 29526-8964 (843) 399-4848 (843) 497-5323 (843) 347-8953 Fax: (843) 399-4409 Fax: (843) 497-5314 Fax: (843) 347-0226 Mon - Fri 8:00 to 5:00 Mon - Thu 8:00 to 5:00 Mon - Thu 8:00 to 5:00 PCMH: No Fri 8:00 to 12:00 Fri 8:00 to 12:00 PCMH: No PCMH: No Floyd, Erin PA Provider ID: 1990767 Harley, Jessica PA Buchanan, Blaine PA Gender: Female Provider ID: 2127584 Provider ID: 2377352 Cpg Internal Medicine Creel Street Gender: Female Gender: Male 1301 Creel St Grand Strand Surgical Specialists Grand Strand Heart Vascular Care Conway, SC 29527-5018 199 Vlg Ctr Blvd, Ste 100 920 Doug White Dr, Ste 510 (843) 248-4414 Myrtle Beach, SC 29579-3589 Myrtle Beach, SC 29572-4183 Fax: (843) 248-3781 (843) 497-6348 (843) 497-7772 Mon - Thu 8:00 to 5:00 Fax: (843) 236-1500 Fax: (843) 848-7530 Fri 8:00 to 1:00 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No Frye, Fritz PA Harris, Larry PA Deshon, Laurie PA Provider ID: 1796129 Provider ID: 1190819 Provider ID: 1769134 Gender: Male Gender: Male Gender: Female Cpg Primary Care @ Carolina Forest Roper St Francis Physician Partners Doctors Care Surfside Medical 4022 Postal Way 4823 Hwy 17 N, Ste B Cente Myrtle Beach, SC 29579-3537 Murrells Inlet, SC 29576-5037 1600 Highway 17 N (843) 236-0000 (843) 723-8823 Surfside Bch, SC 29575-6015 Fax: (843) 236-6191 Fax: (843) 766-6551 (843) 238-1461 Mon - Fri 8:00 to 5:00 Mon - Fri 9:00 to 5:00 Fax: (843) 828-0622 Sat 8:00 to 1:00 PCMH: No Mon - Sun 8:00 to 8:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 217 38642781

Allied Providers Horry Physician Assistant - cont. Loomis, Alexandra PA Robinson, Christopher PA Provider ID: 1789364 Provider ID: 1191058 Herrington, Susan PA Gender: Female Gender: Male Provider ID: 2023242 Doctors Care Market Commons Roper St. Francis Physician Partner Gender: Female 2761 Agnes Ln 4630 Highway 17 Coastal Carolina Primary Care LLC Myrtle Beach, SC 29577 Murrells Inlet, SC 29576-5016 4959 Hwy 17 Bypass South (843) 492-2710 (843) 958-1281 Murrells Inlet, SC 29576 Fax: (843) 492-2708 Fax: (843) 958-1278 (843) 357-1299 Mon - Sun 8:00 to 8:00 Mon - Fri 9:00 to 5:00 Fax: (843) 357-2264 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Melgar, Tammy PA Roode, Richard PA Provider ID: 1206817 Provider ID: 1206854 Landers, Summer PA Gender: Female Gender: Male Provider ID: 1190925 Doctors Care Surfside Doctors Care Strand Gender: Female 1600 Highway 17 N 1221 21st Ave N Roper St Francis Physician Partners Myrtle Beach, SC 29575-6015 Myrtle Beach, SC 29577-7401 4823 Hwy 17 N, Ste B (843) 238-1461 (843) 626-9379 Murrells Inlet, SC 29576-5037 Fax: (843) 828-0622 Fax: (843) 448-0707 (843) 723-8823 Mon - Sun 8:00 to 8:00 Mon - Sun 8:00 to 8:00 Fax: (843) 766-6551 PCMH: No PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No Middleton, Jessica PA Sedwick, Carly PA Provider ID: 1190984 Provider ID: 2025742 Lewis, John PA Gender: Female Gender: Female Provider ID: 1240251 Roper St. Francis Physician Partner Grand Strand Surgical Specialists Gender: Male 4630 Highway 17 933 Medical Circle Mcleod Orthopaedics Seacoast N. Charleston, SC 29576-5016 Myrtle Beach, SC 29572-4116 3980 Highway 9 E, Ste 200 (843) 720-8490 (843) 497-7772 Little River, SC 29566 Fax: (843) 606-8063 Fax: (843) 497-7627 (843) 390-0100 Mon - Fri 9:00 to 5:00 Mon - Fri 9:00 to 5:00 Fax: (843) 390-0038 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Offenback, Richard PA Shaver, Robin PA Provider ID: 1758873 Provider ID: 1769221 Long, Kristina PA Gender: Male Gender: Female Provider ID: 1466839 Doctors Care Conway 501 Doctors Care Strand Gender: Female 1113 Church St 1221 21st Avenue North Georgetown Physician Associates Conway, SC 29526 Myrtle Beach, SC 29577-7401 LLC (843) 248-6269 (843) 626-9379 11891 Plaza Dr Fax: (843) 248-0535 Fax: (843) 448-0707 Murrells Inlet, SC 29576 Mon - Sun 8:00 to 8:00 Mon - Sun 8:00 to 8:00 (843) 353-0288 PCMH: No PCMH: No Fax: (843) 357-9770 Mon - Thu 8:00 to 5:00 Fri 8:00 to 12:00 Phillips, Morgan PA Stevens, Jimmy PA PCMH: No Provider ID: 2025667 Provider ID: 2286724 Gender: Female Gender: Male Grand Strand Surgical Specialists Grand Strand Orthopedic Care 933 Medical Circle 920 Doug White Dr, Ste 130 Myrtle Beach, SC 29572-4116 Myrtle Beach, SC 29572-4180 (843) 497-7772 (843) 848-1440 Fax: (843) 497-7627 Fax: (843) 839-1654 Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 218 38642781

Allied Providers Horry Physician Assistant - cont. Turner, Amy PA Podiatry Provider ID: 1191112 Troutman, Ina PA Gender: Female Mctavish, Joseph PA Provider ID: 1800548 Roper St Francis Physician Partners Provider ID: 1190978 Gender: Female 4630 Highway 17 Gender: Male Cmc Pediatrics-Socastee Murrells Inlet, SC 29576-5016 Roper St Francis Physician Partners 6010 Hwy 707, Ste 100 (843) 724-2011 4823 Hwy 17 N, Ste B Myrtle Beach, SC 29588-7321 Fax: (843) 402-1839 Murrells Inlet, SC 29576-5037 (843) 293-1005 Mon - Fri 9:00 to 5:00 (843) 723-8823 Fax: (843) 293-1006 PCMH: No Fax: (843) 766-6551 Mon - Tue, Thu 8:00 to 7:00 Mon - Fri 9:00 to 5:00 Wed 8:00 to 7:30 PCMH: No Fri 8:00 to 5:00 Villane, Kaycee PA Provider ID: 2323191 Sat 8:00 to 1:00 Professional Counselor PCMH: No Gender: Female Strand Regional Specialty Associate Murray, David LPC 8170 Rourk St, Ste 150 Provider ID: 2242733 Troutman, Lucia PA Myrtle Beach, SC 29572-4127 Provider ID: 2112300 Gender: Male (843) 449-2336 Coastal Haven Counseling LLC Gender: Female Fax: (843) 497-0625 Grand Strand Dermatology 220 Ronnie Ct, Ste 2 Mon - Fri 8:00 to 5:00 Myrtle Beach, SC 29579-4192 3001 Newcastle Loop PCMH: No Myrtle Beach, SC 29588-4502 (843) 945-0346 (843) 748-9784 Fax: (843) 432-3091 Fax: (843) 215-1211 Physician Assistant Family Medicine Mon - Fri 8:00 to 10:00 Mon - Thu 8:00 to 4:00 Sat 8:00 to 4:00 Miller, Johnathan PA PCMH: No Fri 8:00 to 12:00 Provider ID: 1092292 PCMH: No Gender: Male Tidelands Health Family Medicine Seitzinger, Veronica CSW Troutman, Lucia PA 2347 S Hwy 17 Provider ID: 2371172 Provider ID: 2112300 Garden City, SC 29576-7611 Gender: Female Gender: Female (843) 357-2443 Coastal Haven Counseling LLC Grand Strand Dermatology Fax: (843) 357-2132 220 Ronnie Ct, Ste 2 933 Medical Cir Mon - Fri 8:00 to 5:30 Myrtle Beach, SC 29579-4192 Myrtle Beach, SC 29572-4116 PCMH: No (843) 945-0346 (843) 215-1100 Fax: (843) 432-3091 Mon - Thu, Sun 8:00 to 10:0 Fax: (843) 215-1211 Physician Assistant Orthopedics Mon - Fri 9:00 to 5:00 Fri 8:00 to 5:00 PCMH: No Prather, Landon PA Sat 9:00 to 5:00 Provider ID: 1609108 PCMH: No Tumbleson, Catherine PA Gender: Male Provider ID: 1767179 Georgetown Physician Associates Ll Sloan, Theresa LPC Gender: Female 4040 Highway 17, Unit 101 Provider ID: 2047440 Doctors Care Carolina Forest Murrells Inlet, SC 29576-5098 Gender: Female 200 Middleburg Dr (843) 652-8160 The Counseling Center Of Myrtle Beach, SC 29579-3408 Fax: (843) 652-8161 Sayebrook (843) 903-6650 Mon - Fri 8:00 to 4:30 106 Lansford Pl, Ste 202 Fax: (843) 903-0758 PCMH: No Myrtle Beach, SC 29588-6979 Mon - Fri 8:00 to 8:00 (843) 213-2659 Sat 9:00 to 5:00 Fax: (843) 213-6231 Sun 9:00 to 6:00 Mon - Thu 8:00 to 4:00 PCMH: No Fri 8:00 to 2:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 219 38642781

Allied Providers Horry Professional Counselor - cont. Blakely Wheeler, Valerie SLP Combs, Susan SLP Provider ID: 1523768 Provider ID: 1695895 Talbert, Wendy LPC Gender: Female Gender: Female Provider ID: 1989742 Therapy Consortium Inc Therapy Consortium Inc Gender: Female 4761 Highway 501, Ste 1 4761 Hwy 501, Ste 1 Columbia Counseling Myrtle Beach, SC 29579-9457 Myrtle Beach, SC 29579-9457 Center/Columbia (843) 455-7505 (843) 455-7505 220 Ronnie Ct, Ste 2 Mon - Fri 9:00 to 6:30 Mon - Fri 8:00 to 6:00 Myrtle Beach, SC 29579-4192 PCMH: No PCMH: No (843) 945-0346 Fax: (843) 432-3091 Mon - Fri 8:00 to 8:00 Britt, Josie SLP Crowninshield, Jessica SLP Sat 8:00 to 3:00 Provider ID: 2014158 Provider ID: 1432409 PCMH: No Gender: Female Gender: Female Therapy Consortium Inc Therapy Consortium Inc 4761 Highway 501, Ste 1 4761 Highway 501, Ste 1 Vanhoogen, Ut Uyen LPC Myrtle Beach, SC 29579-9457 Myrtle Beach, SC 29579-9457 Provider ID: 2370070 (843) 236-9751 (843) 455-7505 Gender: Female Fax: (866) 571-1014 Fax: (866) 571-1014 Little River Medical Center Inc Mon - Fri 8:00 to 6:00 Mon - Fri 8:00 to 6:00 4303 Live Oak Dr PCMH: No PCMH: No Little River, SC 29566-9138 (843) 663-8000 Mon, Wed 8:00 to 7:00 Brown, Natalie SLP Cusack, Shemeka SLP Tue, Thu - Fri 8:00 to 5:30 Provider ID: 1789055 Provider ID: 2135056 PCMH: No Gender: Female Gender: Female Therapy Consortium Inc Therapy Consortium Inc 4761 Highway 501, Ste 1 4761 Highway 501, Ste 1 Speech & Language Pathology Myrtle Beach, SC 29579-9457 Myrtle Beach, SC 29579-9457 Ard, Kimberly SLP (843) 455-7505 (843) 236-9751 Provider ID: 1469169 Fax: (843) 455-7505 Fax: (866) 571-1014 Gender: Female Mon - Fri 8:00 to 6:00 Mon - Fri 8:00 to 6:00 Therapy Consortium Inc. PCMH: No PCMH: No 4761 Highway 501, Ste 1 Myrtle Beach, SC 29579 Burch, Bridget SLP Dinello, Kaylee SLP (843) 455-7505 Provider ID: 2363300 Provider ID: 1604484 Fax: (866) 571-1014 Gender: Female Gender: Female Mon - Fri 9:00 to 6:30 Therapy Consortium Inc. Therapy Consortium PCMH: No 4761 Highway 501, Ste 1 4761 Hwy 501, Ste 1 Myrtle Beach, SC 29579-9457 Myrtle Beach, SC 29579-9457 Bellavia, Lisa SLP (843) 455-7505 (843) 455-7505 Provider ID: 1543342 Fax: (866) 571-1014 Mon 8:00 to 6:30 Gender: Female Mon - Fri 8:00 to 6:00 Tue - Fri 8:00 to 6:00 Therapy Consortium PCMH: No PCMH: No 4761 Highway 501, Ste 1 Myrtle Beach, SC 29579-9457 Carey, Amanda SLP Fitzpatrick, Christine SLP (843) 455-7505 Provider ID: 2186264 Provider ID: 1433910 Fax: (866) 571-1014 Gender: Female Gender: Female Mon - Fri 8:00 to 6:00 Therapy Consortium Inc. Therapy Consortium Inc PCMH: No 4761 Highway 501, Ste 1 4761 Hwy 501, Ste 1 Myrtle Beach, SC 29579-9457 Myrtle Beach, SC 29579-9457 (843) 236-9751 (843) 455-7505 Fax: (866) 571-1014 Mon - Fri 9:00 to 6:30 Mon 8:00 to 6:30 PCMH: No Tue - Fri 8:00 to 6:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 220 38642781

Allied Providers Horry Speech & Language Pathology - Johnson, Nia SLP Lehman, Annie SLP cont. Provider ID: 2237570 Provider ID: 1200981 Gender: Female Gender: Female Frye, Amanda SLP Therapy Consortium Inc. Therapy Consortium Inc. Provider ID: 1696448 4761 Highway 501, Ste 1 4761 Highway 501, Ste 1 Gender: Female Myrtle Beach, SC 29579-9457 Myrtle Beach, SC 29579 Therapy Consortium Inc (843) 236-9751 (843) 455-7505 4761 Highway 501, Ste 1 Fax: (866) 571-1014 Fax: (866) 571-1014 Myrtle Beach, SC 29579 Mon - Fri 8:00 to 6:00 Mon - Fri 9:00 to 6:30 (843) 455-7505 PCMH: No PCMH: No Fax: (866) 571-1014 Mon - Fri 8:00 to 6:00 Jones, Michelle SLP Merriman, Lisa SLP PCMH: No Provider ID: 1194650 Provider ID: 1773794 Gender: Female Gender: Female Gibbons, Laura SLP Therapy Consortium Therapy Consortium Inc. Provider ID: 2359966 4761 Highway 501, Ste 1 4761 Highway 501, Ste 1 Gender: Female Myrtle Beach, SC 29579 Myrtle Beach, SC 29579-9457 Therapy Consortium (843) 455-7505 (843) 455-7505 4761 Highway 501, Ste 1 Mon - Fri 9:00 to 6:30 Fax: (866) 571-1014 Myrtle Beach, SC 29579-9457 PCMH: No Mon - Fri 8:00 to 6:00 (843) 236-9751 PCMH: No Fax: (866) 571-1014 Jones Brown, Jacqueline SLP Mon - Fri 8:00 to 6:00 Provider ID: 1833579 Palmer, Susan SLP PCMH: No Gender: Female Provider ID: 1472131 Therapy Consortium Inc Gender: Female Glover, Farrah SLP 4761 Highway 501, Ste 1 Therapy Consortium Inc. Provider ID: 1697128 Myrtle Beach, SC 29579-9457 4761 Highway 501, Ste 1 Gender: Female (843) 236-9751 Myrtle Beach, SC 29579 Therapy Consortium Inc Mon - Fri 8:00 to 6:00 (843) 455-7505 4761 Highway 501, Ste 1 PCMH: No Fax: (866) 571-1041 Myrtle Beach, SC 29579-9457 Mon - Fri 9:00 to 6:30 (843) 455-7505 Kellahan, Meredith SLP PCMH: No Mon - Fri 8:00 to 6:00 Provider ID: 1594267 PCMH: No Gender: Female Price, Stacie SLP Therapy Consortium Inc Provider ID: 1539808 Goings, Charity SLP 4761 Highway 501, Ste 1 Gender: Female Provider ID: 2385997 Myrtle Beach, SC 29579-9457 Therapy Consortium Gender: Female (843) 236-9751 4761 Highway 501, Ste 1 Therapy Consortium Inc. Fax: (866) 571-1014 Myrtle Beach, SC 29579-9457 4761 Highway 501, Ste 1 Mon - Fri 8:00 to 6:00 (843) 455-7505 Myrtle Beach, SC 29579-9457 PCMH: No Fax: (866) 571-1014 (843) 236-9751 Mon - Fri 8:00 to 6:00 Mon - Fri 8:00 to 6:00 Lawrence, Emily SLP PCMH: No PCMH: No Provider ID: 2378558 Gender: Female Rogers, Cheryl SLP Therapy Consortium Provider ID: 1574540 4761 Highway 501, Ste 1 Gender: Female Myrtle Beach, SC 29579-9457 Therapy Consortium Inc (843) 455-7505 4761 Highway 501, Ste 1 Fax: (866) 571-1014 Myrtle Beach, SC 29579-9457 Mon - Fri 8:00 to 6:00 (843) 455-7505 PCMH: No Mon - Fri 8:00 to 6:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 221 38642781

Allied Providers Horry Speech & Language Pathology - Walker, James SLP Speech Therapy cont. Provider ID: 1468456 Gender: Male Abushakra, Kimberly SLP Stephenson, Jennifer SLP Therapy Consortium Inc. Provider ID: 1286597 Provider ID: 1816587 4761 Highway 501, Ste 1 Gender: Female Gender: Female Myrtle Beach, SC 29579 Speech And Language Services Speech By The Beach Inc. (843) 455-7505 1016 2nd Ave N, Ste 102 2126 Highway 9 E, Ste C4 Fax: (866) 571-1014 North Myrtle Beach, SC 29582-3287 Longs, SC 29568-5753 Mon - Fri 8:00 to 6:00 (843) 491-3572 (843) 734-1076 PCMH: No Fax: (843) 491-3573 Fax: (843) 734-1107 Mon - Thu 8:00 to 5:00 PCMH: No Mon - Thu 8:00 to 5:00 Warren, Michelle SLP Fri 8:00 to 12:00 Provider ID: 1433268 PCMH: No Gender: Female Berry, Jessica SLP Therapy Consortium Inc. Provider ID: 1249517 Stewart, Danielle SLP 4761 Highway 501, Ste 1 Gender: Female Provider ID: 1829423 Myrtle Beach, SC 29579-9457 Therapy Consortium Inc Gender: Female (843) 455-7505 4761 Highway 501, Ste 1 Therapy Consortium Inc. Fax: (866) 571-1014 Myrtle Beach, SC 29579 4761 Highway 501, Ste 1 Mon - Fri 9:00 to 6:30 (843) 455-7505 Myrtle Beach, SC 29579-9457 PCMH: No Fax: (866) 571-1014 (843) 455-7505 Mon - Fri 9:00 to 6:30 PCMH: No Fax: (866) 571-1014 Weingart, Kristin SLP Mon - Fri 8:00 to 6:00 Provider ID: 2202413 PCMH: No Gender: Female Brooks, Jennifer SLP Therapy Consortium Inc. Provider ID: 773562 Truesdale, Lakisha SLP 4761 Highway 501, Ste 1 Gender: Female Provider ID: 2246949 Myrtle Beach, SC 29579-9457 Therapy Consortium Gender: Female (843) 236-9751 4761 Highway 501, Ste 1 Therapy Consortium Inc Fax: (866) 571-1014 Myrtle Beach, SC 29579-9457 4761 Highway 501, Ste 1 Mon - Fri 8:00 to 6:00 (843) 236-9751 Myrtle Beach, SC 29579-9457 PCMH: No Fax: (843) 236-9765 (843) 455-7505 Mon - Thu 9:00 to 5:00 Fax: (866) 571-1014 Fri 9:00 to 9:00 White, Cameron SLP PCMH: No Mon - Sun 9:00 to 6:30 Provider ID: 2005273 PCMH: No Gender: Male Therapy Consortium Inc. Cotter, Priscilla SLP Valrie, Teah SLP 4761 Highway 501, Ste 1 Provider ID: 926066 Provider ID: 1638306 Myrtle Beach, SC 29579-9457 Gender: Female Gender: Female (843) 236-9751 Therapy Consortium Inc Therapy Consortium Inc Fax: (866) 571-1014 4761 Highway 501, Ste 1 4761 Highway 501, Ste 1 Mon - Fri 8:00 to 6:00 Myrtle Beach, SC 29579-9457 Myrtle Beach, SC 29579-9457 PCMH: No (843) 455-7505 (843) 455-7505 Fax: (866) 571-1014 Mon - Fri 8:00 to 5:00 Mon - Fri 9:00 to 6:30 Wilson, Tanya SLP PCMH: No PCMH: No Provider ID: 1194651 Gender: Female Therapy Consortium Inc 4761 Highway 501, Ste #1 Myrtle Beach, SC 29579 (843) 283-2502 Fax: (866) 571-1014 Mon - Fri 9:00 to 6:30 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 222 38642781

Allied Providers Horry Speech Therapy - cont. Hunter, Lauren SLP Lloyd, Quincey SLP Provider ID: 931170 Provider ID: 1249505 Dawson, Michelle SLP Gender: Female Gender: Female Provider ID: 1276524 Doyle Nobles LLC Young Talkers LLC Gender: Female 2540b Highway 501 E 8703 Highway 17 Bypass, Ste I Therapy Consortium Inc Aynor, SC 29511-3477 Myrtle Beach, SC 29575-7701 4761 Highway 501, Ste 1 (843) 358-1457 (843) 457-1053 Myrtle Beach, SC 29579 Fax: (843) 358-1458 Fax: (843) 215-2910 (843) 455-7505 Mon - Fri 9:00 to 5:00 Mon - Thu 8:00 to 6:00 Fax: (866) 571-1014 PCMH: No Fri 8:00 to 12:00 Mon - Fri 80:00 to 5:00 PCMH: No PCMH: No Ivy, Amy Provider ID: 924959 Lowe, Lisa SLP Evans, Tonya SLP Gender: Female Provider ID: 776785 Provider ID: 770056 Therapy Consortium Inc Gender: Female Gender: Female 4761 Highway 501, Ste 1 One Stop Therapy 4 Kids Therapy Consortium Inc Myrtle Beach, SC 29579-9457 3140 Bayhaven Dr 4761 Highway 501, Ste 1 (843) 455-7505 Myrtle Beach, SC 29579-1821 Myrtle Beach, SC 29579-9457 Fax: (866) 571-1014 (843) 903-5455 (843) 455-7505 Mon - Fri 9:00 to 6:30 Mon - Fri 9:00 to 5:00 Fax: (866) 571-1014 PCMH: No PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No Lary, Andrea SLP Lowe, Lisa SLP Provider ID: 773585 Provider ID: 776785 Ferguson, Kimberly SLP Gender: Female Gender: Female Provider ID: 1274079 Therapy Consortium Inc One Stop Therapy 4 Kids Gender: Female 4761 Highway 501, Ste 1 4201 Carolina Exchange Dr, Ste 102 Therapy Consortium Myrtle Beach, SC 29579-9457 Myrtle Beach, SC 29579-4394 4761 Highway 501, Ste 1 (843) 455-7505 (843) 236-9751 Myrtle Beach, SC 29579 Fax: (866) 571-1014 Mon - Fri 9:00 to 5:00 (843) 455-7505 Mon - Fri 9:00 to 5:00 PCMH: No Fax: (866) 571-1014 PCMH: No Mon - Fri 9:00 to 6:30 PCMH: No Mahaffey, Kathryn SLP Leninger, Katherine SLP Provider ID: 774686 Provider ID: 775985 Gender: Female Harmon, Tonya SLP Gender: Female Therapy Consortium Inc Provider ID: 771754 Therapy Consortium Inc 4761 Highway 501, Ste 1 Gender: Female 4761 Highway 501, Ste 1 Myrtle Beach, SC 29579-9457 Therpay Consortium Inc Myrtle Beach, SC 29579-9457 (843) 455-7505 4761 Highway 501, Ste 1 (843) 455-7505 Fax: (866) 571-1014 Myrtle Beach, SC 29579-9457 Fax: (866) 571-1014 Mon - Fri 9:00 to 5:00 (843) 455-7505 Mon - Fri 9:00 to 5:00 PCMH: No Fax: (866) 571-1014 PCMH: No Mon - Thu 9:00 to 6:30 Fri 7:30 to 4:30 Mcafee, Leticia SLP PCMH: No Provider ID: 924966 Gender: Female Therapy Consortium Inc 4761 Highway 501, Ste 1 Myrtle Beach, SC 29579-9457 (843) 455-7505 Fax: (866) 571-1014 Mon - Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 223 38642781

Allied Providers Horry Speech Therapy - cont. Parent, Jennifer SLP Soles, Margaret SLP Provider ID: 918065 Provider ID: 903275 Mezzatesta, Patricia SLP Gender: Female Gender: Female Provider ID: 772148 Young Talkers LLC Therapy Consortium Inc Gender: Female 8703 Highway 17 Byp S, Ste I 4761 Highway 501, Ste 1 Therapy Consortium Inc Myrtle Beach, SC 29575 Myrtle Beach, SC 29579-9457 4761 Highway 501, Ste 1 (843) 457-1053 (843) 455-7505 Myrtle Beach, SC 29579-9457 Fax: (843) 215-2910 Fax: (866) 571-1014 (843) 455-7505 Mon - Fri 9:00 to 6:00 Mon - Fri 9:00 to 6:30 Fax: (866) 571-1014 PCMH: No PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No Pendergrass, Kimberly SLP Walter, Lauren SLP Provider ID: 926064 Provider ID: 908345 Minter, Andrea SLP Gender: Female Gender: Female Provider ID: 770830 Therapy Consortium Inc Therapy Consortium Inc Gender: Female 4761 Highway 501, Ste 1 4761 Highway 501, Ste 1 Therapy Consortium Inc Myrtle Beach, SC 29579-9457 Myrtle Beach, SC 29579-9457 4761 Highway 501, Ste 1 (843) 455-7505 (843) 455-7505 Myrtle Beach, SC 29579-9457 Fax: (866) 571-1014 Fax: (866) 571-1014 (843) 455-7505 Mon - Fri 9:00 to 6:30 Mon - Sun 9:00 to 6:30 Fax: (866) 571-1014 PCMH: No PCMH: No Mon - Fri 9:00 to 5:00 PCMH: No Peterson, Barbara SLP Wheeler, Betty SLP Provider ID: 926060 Provider ID: 773219 Murdaugh, Monica SLP Gender: Female Gender: Female Provider ID: 774713 Therapy Consortium Inc Therapy Consortium Inc Gender: Female 4761 Highway 501, Ste 1 4761 Highway 501, Ste 1 Therapy Consortium Inc Myrtle Beach, SC 29579-9457 Myrtle Beach, SC 29579-9457 4761 Highway 501, Ste 1 (843) 455-7505 (843) 455-7505 Myrtle Beach, SC 29579-9457 Fax: (866) 571-1014 Fax: (866) 571-1014 (843) 455-7505 Mon - Fri 9:00 to 6:30 Mon - Fri 9:00 to 5:00 Mon - Fri 9:00 to 5:00 PCMH: No PCMH: No PCMH: No Rogers, Susan SLP Williams, Ricki SLP Oliver, Elizabeth SLP Provider ID: 1170367 Provider ID: 771875 Provider ID: 1185335 Gender: Female Gender: Female Gender: Female Therapy Consortium Inc. Therapy Consortium Inc Therapy Consortium Inc 4761 Highway 501, Ste 1 4761 Highway 501, Ste 1 4761 Highway 501, Ste 501 Myrtle Beach, SC 29579 Myrtle Beach, SC 29579-9457 Myrtle Beach, SC 29579 (843) 455-7505 (843) 455-7505 (843) 455-7505 Fax: (866) 571-1014 Fax: (866) 571-1014 Fax: (866) 571-1014 Mon - Fri 9:00 to 6:30 Mon - Fri 9:00 to 5:00 Mon - Fri 8:30 to 7:00 PCMH: No PCMH: No PCMH: No Schank, Stephanie SLP Young-Cline, Nicole SLP Provider ID: 1999859 Provider ID: 775259 Gender: Female Gender: Female Therapy Consortium Inc. Young Talkers LLC 4761 Highway 501, Ste 1 8703 Highway 17 Byp S, Ste I Myrtle Beach, SC 29579-9457 Myrtle Beach, SC 29575 (843) 236-9751 (843) 457-1053 Fax: (866) 571-1014 Fax: (843) 215-2910 Mon - Fri 8:00 to 6:00 Mon - Fri 9:00 to 6:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 224 38642781

Allied Providers Horry Speech Therapy - cont. Crawford, Rebecca APRN Deeney, Michelle PA Provider ID: 1082304 Provider ID: 1079413 Zito, Caroline SLP Gender: Female Gender: Female Provider ID: 1276039 Atlantic Urology Clinics LLC Atlantic Urology Clinics LLC Gender: Female 402 Singleton Ridge Road 5046 Highway 17 Byp S, Ste 200 Therapy Consortium Inc Conway, SC 29526 Myrtle Beach, SC 29588-4503 4761 Highway 501, Ste 1 (843) 347-0267 (843) 347-2450 Myrtle Beach, SC 29579 Fax: (843) 347-0346 Fax: (843) 293-0448 (843) 455-7505 Conway Medical Center Mon - Tue 8:00 to 5:00 Fax: (866) 571-1014 Mon - Fri 8:00 to 5:00 PCMH: No Mon - Fri 9:00 to 6:30 PCMH: No PCMH: No Joyner, Debra PA Deeney, Michelle PA Provider ID: 958856 Thoracic & Cardiovascular Surgery Provider ID: 1079413 Gender: Female Atlantic Urology Clinics LLC Stokes, Ernest PA Gender: Female Atlanic Urology Clinics LLC 3600 Sea Mountain Hwy, Ste D Provider ID: 1043737 Little River, SC 29566-8161 Gender: Male 3600 Sea Mountain Hwy, Ste B Little River, SC 29566-8161 (843) 399-8930 Grand Strand Heart And Vascular Fax: (843) 399-8932 Spe (843) 280-5151 Fax: (843) 399-9596 Mon - Fri 9:00 to 5:00 933 Medical Cir PCMH: No Myrtle Beach, SC 29572-4116 Mon - Fri 8:00 to 5:00 (843) 497-7772 PCMH: No Fax: (843) 497-7627 Joyner, Debra PA Grand Strand Regional Medical Deeney, Michelle PA Provider ID: 958856 Center Provider ID: 1079413 Gender: Female Mon - Fri 9:00 to 5:00 Gender: Female Atlantic Urology Clinics LLC PCMH: No Atlantic Urology Clinics LLC 402 Singleton Ridge Rd 823 82nd Pkwy, Unit 110 Conway, SC 29526-9153 (843) 347-0267 Urology Myrtle Beach, SC 29572-4607 (843) 347-2450 Fax: (843) 347-0346 Crawford, Rebecca APRN Fax: (843) 497-6171 Mon - Fri 8:00 to 5:00 Provider ID: 1082304 Mon - Fri 8:00 to 5:00 PCMH: No Gender: Female PCMH: No Atlantic Urology Clinics LLC Joyner, Debra PA 3600 Sea Mountain Hwy, Ste D Deeney, Michelle PA Provider ID: 958856 Little River, SC 29566-8161 Provider ID: 1079413 Gender: Female (843) 399-8930 Gender: Female Atlantic Urology Clinics LLC Fax: (843) 399-8932 Atlantic Urology Clinics LLC 101 Mcleod Health Blvd, Ste 202 Conway Medical Center 101 Mcleod Health Blvd, Ste 202 Myrtle Beach, SC 29579-4477 Mon - Fri 9:00 to 5:00 Myrtle Beach, SC 29579-4477 (843) 236-5004 PCMH: No (843) 347-2450 Fax: (843) 236-4746 Fax: (843) 236-4746 Mon - Fri 9:00 to 5:00 Crawford, Rebecca APRN Mon - Fri 9:00 to 5:00 PCMH: No Provider ID: 1082304 PCMH: No Gender: Female Joyner, Debra PA Atlantic Urology Clinics LLC Provider ID: 958856 101 Mcleod Health Blvd, Ste 202 Gender: Female Myrtle Beach, SC 29579-4477 Atlantic Urology Clinics (843) 347-2450 394 Singleton Ridge Rd Fax: (843) 236-4746 Conway, SC 29526-9150 Conway Medical Center (843) 347-8765 Mon - Fri 9:00 to 5:00 Fax: (843) 347-3499 PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 225 38642781

Allied Providers Horry Urology - cont. Lawrence, Melanie APRN Provider ID: 1118719 Gender: Female Atlantic Urology Clinics LLC 3600 Sea Mountain Hwy, Ste D Little River, SC 29566-8161 (843) 399-8930 Fax: (843) 399-8932 Mon - Fri 9:00 to 5:00 PCMH: No

Lawrence, Melanie APRN Provider ID: 1118719 Gender: Female Atlantic Urology Clinics LLC 394 Singleton Ridge Rd Conway, SC 29526-9150 (843) 347-8765 Fax: (843) 347-3499 Mon - Fri 8:00 to 5:00 PCMH: No

Lawrence, Melanie APRN Provider ID: 1118719 Gender: Female Atlantic Urology Clinics LLC 402 Singleton Ridge Rd Conway, SC 29526-9153 (843) 347-0267 Fax: (843) 347-0346 Mon - Fri 8:00 to 5:00 PCMH: No

Lawrence, Melanie APRN Provider ID: 1118719 Gender: Female Atlantic Urology Clinics LLC 101 Mcleod Health Blvd, Ste 202 Myrtle Beach, SC 29579-4477 (843) 236-5004 Fax: (843) 236-4746 Mon - Fri 9:00 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 226 38642781

Allied Providers Marion Federally Qualified Health Center Nurse Practitioner Family Medicine Professional Counselor Painter, Autumn APRN Gulledge, Paul APRN Brown, Anita LPC Provider ID: 2148094 Provider ID: 2320073 Provider ID: 2144683 Gender: Female Gender: Male Gender: Female Health Care Partners Of Sc Inc. Mcleod Family Medicine Marion Children And Families Matter Llc. 145 Palmetto Pointe Rd Count 210 E Dozier St Marion, SC 29571-6721 3032 E Highway 76 Marion, SC 29571-3014 (843) 488-6030 Mullins, SC 29574-7396 (843) 229-7931 Fax: (877) 322-0181 (843) 777-7780 Mon - Fri 4:00 to 9:00 Mon - Fri 8:00 to 5:00 Fax: (843) 292-7324 Sat 9:00 to 5:00 Sat 8:00 to 12:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No PCMH: No Speech & Language Pathology Licensed Professional Counselor Painter, Autumn APRN Provider ID: 2148094 Mason, Rachel SLP Jenkins, Cynthia LPC Gender: Female Provider ID: 1525808 Provider ID: 1855071 Health Care Partners Of Sc Inc. Gender: Female Gender: Female 145 Palmetto Pointe Rd Remcare Speech Services Creative Counseling And Behavioral Marion, SC 29571-6721 500 N Main St, Ste A-8 304 W Bond St (843) 488-6030 Marion, SC 29571-3032 Marion, SC 29571-3530 Fax: (877) 322-0181 (843) 423-9998 (843) 260-8824 Mon - Fri 8:00 to 5:00 Fax: (843) 423-9928 Fax: (843) 765-3468 Sat 8:00 to 12:00 Mon - Wed, Fri 9:00 to 5:00 Mon - Fri 8:30 to 5:00 PCMH: No Thu 9:30 to 5:00 PCMH: No Sat 10:00 to 12:00 PCMH: No Physical Therapy Licensed Social Worker Baslot, Joel PT Speech Therapy Stoney, Gertrude CSW Provider ID: 774701 Provider ID: 2393573 Gender: Male Elliott, Rebecca SLP Gender: Female Joel N Baslot PT LLC Provider ID: 775612 Health Care Partners Of Sc 2236 E Highway 76, Ste A Gender: Female 145 Palmetto Pointe Rd Marion, SC 29571 Speak Up Therapy Services Marion, SC 29571-6721 (843) 423-4888 214 Presbyterian St (843) 488-6030 Fax: (843) 423-4849 Marion, SC 29571 Fax: (877) 322-0181 Mon - Thu 8:30 to 12:00 (843) 615-1224 Mon - Fri 8:00 to 5:00 Fri 8:30 to 3:30 Fax: (843) 275-0506 PCMH: No PCMH: No Mon - Fri 8:00 to 5:00 PCMH: No Nurse Practitioner Physician Assistant Thompkins, Kathy APRN Strickland, Gwendolyn PA Provider ID: 767738 Provider ID: 909823 Gender: Male Gender: Female Palmetto Medical Care Marion Medical Group 1002 S Main St 1205 N Main St Mullins, SC 29574 Marion, SC 29571-2008 (843) 464-8205 (843) 423-0760 Fax: (843) 464-8206 Fax: (843) 423-8136 Mon - Fri 9:00 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 227 38642781

Allied Providers Marlboro Clinical Social Work Mishra, Ellen ARNP Smith, Robert CSW Provider ID: 768030 Provider ID: 1868572 Brown, Elizabeth LCSW Gender: Female Gender: Male Provider ID: 817367 Csc Bennettsville R&c Consulting Group Inc. Gender: Female Subspecialty: HRSA FQHC 404 S Main St Caresouth Carolina 999 Cheraw St Mc Coll, SC 29570-1202 225 S Main St Bennettsville, SC 29512-2420 (843) 400-4407 Mc Coll, SC 29570-2020 (843) 479-2341 Fax: (843) 400-4408 (843) 523-5751 Fax: (843) 479-2346 Mon - Fri 8:00 to 5:00 Fax: (843) 523-6040 Mon - Fri 8:30 to 5:00 Sat 8:00 to 12:00 Mon - Fri 9:00 to 5:00 PCMH: No PCMH: No PCMH: No Mishra, Ellen ARNP Licensed Marriage And Family Family Practice Provider ID: 995175 Therapist Mishra, Ellen ARNP Gender: Female Provider ID: 995175 Caresouth Carolina Inc Beres, Danielle LMFT Gender: Female Subspecialty: HRSA FQHC Provider ID: 2251995 Caresouth Carolina Inc 999 Cheraw St Gender: Female Subspecialty: HRSA FQHC Bennettsville, SC 29512-2420 Thrive Community Services LLC 999 Cheraw St (843) 479-2341 111 Clyde St Bennettsville, SC 29512-2420 Fax: (843) 479-2346 Bennettsville, SC 29512-3117 (843) 479-2341 Mon - Fri 8:30 to 5:00 (843) 353-8934 Fax: (843) 479-2346 PCMH: No Fax: (843) 545-6023 Mon - Fri 8:30 to 5:00 Mon - Fri 8:00 to 5:00 PCMH: No Mishra, Ellen ARNP Sat 9:00 to 3:00 Provider ID: 995175 PCMH: No Mishra, Ellen ARNP Gender: Female Provider ID: 995175 Caresouth Carolina Inc Licensed Professional Counselor Subspecialty: HRSA FQHC Gender: Female Banda, Darlinda LPC Caresouth Carolina Inc 999 Cheraw St Bennettsville, SC 29512-2420 Provider ID: 1348095 Subspecialty: HRSA FQHC Gender: Female 999 Cheraw St (843) 479-2341 Fax: (843) 479-2346 Recovery Behavioral Healthcare Bennettsville, SC 29512-2420 LLC (843) 479-2341 Mon - Fri 8:30 to 5:00 PCMH: No 100 Community Dr Fax: (843) 479-2346 Mc Coll, SC 29570 Mon - Fri 8:30 to 5:00 (910) 273-9956 PCMH: No Licensed Clinical Social Worker Fax: (843) 507-1024 Gore, Rezell LCSW Mon - Fri 9:00 to 5:00 Federally Qualified Health Center Provider ID: 1528199 PCMH: No Mishra, Ellen ARNP Gender: Male Provider ID: 768030 Sandhills Behavioral Center Inc Patterson, Yolanda LPC Gender: Female 404 S Main St Provider ID: 1907966 Csc Bennettsville Mc Coll, SC 29570-1202 Gender: Female Subspecialty: HRSA FQHC (843) 400-5023 R C Consulting Group 999 Cheraw St Fax: (843) 400-5033 404 S Main St Bennettsville, SC 29512-2420 Mon - Fri 8:00 to 5:00 Mc Coll, SC 29570-1202 (843) 479-2341 PCMH: No (843) 400-4407 Fax: (843) 479-2346 Fax: (843) 400-4408 Mon - Fri 8:30 to 5:00 Mon, Wed 8:00 to 9:00 PCMH: No Tue, Thu - Fri 8:00 to 5:00 Sat 10:00 to 6:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 228 38642781

Allied Providers Marlboro Licensed Professional Counselor - Nurse Practitioner Adult Health Pediatrics cont. Little, Earline APRN Atkinson, Meredith APRN Patterson, Yolanda LPC Provider ID: 1239557 Provider ID: 2411816 Provider ID: 2048940 Gender: Female Gender: Female Gender: Female Caresouth Carolina Inc. Mcleod Pediatrics Primary Care Be Inspirational Hope LLC 3080 Highway 15-401 E 1076 Marlboro Way, Ste 3 232 Highway 15-401 Byp E Mc Coll, SC 29570-6128 Bennettsville, SC 29512-2495 Bennettsville, SC 29512-4440 (843) 523-5751 (843) 479-0432 (843) 456-5099 Fax: (843) 523-6040 Fax: (843) 479-3036 Fax: (843) 456-5093 Mon - Fri 8:00 to 5:00 Mon - Fri 8:00 to 5:00 Mon, Wed 8:00 to 9:00 PCMH: No PCMH: No Tue, Thu - Fri 8:00 to 5:00 Sat 10:00 to 6:00 Nurse Practitioner Family Medicine Physical Therapy PCMH: No Bailey, Lauren APRN Imbeau, Nancy PT Provider ID: 2004288 Provider ID: 1174514 Stuckey, Dominica LPC Gender: Female Gender: Female Provider ID: 1478826 Caresouth Carolina Inc. Pro-Motion Physical Therapy Of Gender: Female 999 Cheraw St Flor Atlee Counseling LLC Bennettsville, SC 29512-2420 3080 Highway 15-401, E Drive Suite 241 E Main St (843) 479-2341 B Bennettsville, SC 29512 Fax: (843) 479-2346 Mccoll, SC 29570 (843) 456-5183 Mon - Fri 8:30 to 5:00 (843) 894-1141 Fax: (855) 710-7150 PCMH: No Fax: (843) 894-1142 Mon - Thu 10:00 to 6:00 Mon - Fri 9:00 to 5:00 Fri 10:00 to 7:00 PCMH: No PCMH: No Mckoy, Alexia ARNP Provider ID: 1239555 Gender: Female Smith, Sherry PT Nurse Practitioner Caresouth Carolina Inc Provider ID: 2153503 Mishra, Ellen ARNP 999 Cheraw St Gender: Female Provider ID: 768030 Bennettsville, SC 29512 Pro-Motion Physical Therapy Gender: Female (843) 479-6104 3080 Highway 15-401, E Drive Suite Csc Bennettsville Fax: (843) 479-2346 B Subspecialty: HRSA FQHC Mon - Fri 8:00 to 5:00 Mccoll, SC 29560 999 Cheraw St PCMH: No (843) 894-1141 Bennettsville, SC 29512-2420 Fax: (843) 894-1142 (843) 479-2341 Quick, Sandra ARNP Mon - Thu 8:00 to 6:00 Fax: (843) 479-2346 Provider ID: 1419774 Fri 8:00 to 12:00 Mon - Fri 8:30 to 5:00 Gender: Female PCMH: No PCMH: No Sc House Calls Inc 304 E Market St Sto Domingo, Judie PT Mishra, Ellen ARNP Bennettsville, SC 29512 Provider ID: 772115 Provider ID: 768030 (843) 479-3837 Gender: Female Gender: Female Fax: (843) 479-3931 Marlboro Physical Therapy And Csc Bennettsville Mon - Fri 8:00 to 5:00 Rehab Subspecialty: HRSA FQHC PCMH: No 1021 Cheraw St 999 Cheraw St Bennettsville, SC 29512 Bennettsville, SC 29512-2420 (843) 454-9000 (843) 479-2341 Fax: (843) 454-9001 Fax: (843) 479-2346 Mon - Thu 8:30 to 5:30 Mon - Fri 8:30 to 5:00 Fri 8:30 to 12:00 PCMH: No PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 229 38642781

Allied Providers Marlboro Professional Counselor Johnson, Damien LPC Provider ID: 2275870 Gender: Male Damien Edward Johnson 104 Red Bluff St Clio, SC 29525-3019 (843) 586-0108 Fax: (843) 586-0108 Mon - Fri 9:00 to 7:00 Sat 10:00 to 1:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 230 38642781

Allied Providers Williamsburg Family Practice Wallace, Donya LPC Nurse Practitioner Family Medicine Provider ID: 773971 Morris, Angela APRN Gender: Female Grimsley, Jessica APRN Provider ID: 1221449 Wallace Donya D Provider ID: 1787027 Gender: Female 201 Short St Gender: Female Williamsburg Regional Health Kingstree, SC 29556 Williamsburg Regional Health Center (843) 598-5096 Center 500 Thur Marshall Hwy, Ste F Fax: (843) 354-6461 500 Thurgood Marshall Hwy, Ste F Kingstree, SC 29556 Mon, Wed, Fri 9:00 to 5:00 Kingstree, SC 29556 (843) 355-1772 Tue, Thu 9:00 to 6:00 (843) 355-1772 Fax: (843) 355-1775 PCMH: No Mon - Fri 8:30 to 5:00 Mon - Tue, Thu 8:30 to 5:00 PCMH: No Wed 8:30 to 1:00 Wallace, Donya LPC Fri 8:30 to 4:00 Gulledge, Paul APRN PCMH: No Provider ID: 773971 Gender: Female Provider ID: 1506409 128 E Mill St, Ste A Gender: Male Licensed Clinical Social Worker Kingstree, SC 29556-3428 Mcleod Family Medicine Kingstree (843) 394-8274 512 Nelson Blvd, Ste 200 Graham, Meridith CSW Fax: (843) 354-6461 Kingstree, SC 29556-4027 Provider ID: 2137313 PCMH: No (843) 355-5459 Gender: Female Fax: (843) 355-9704 Hopehealth Kingstree Mon - Fri 8:00 to 5:00 520 Thur Marshall Hwy, Ste B Wells, Terrance LPC PCMH: No Kingstree, SC 29556-4108 Provider ID: 1255191 (843) 355-5628 Gender: Male Fax: (843) 355-5616 Family Support Services LLC Nurse Practitioner Pediatric Mon - Fri 7:30 to 5:00 615 Martin Luther King Ave Hanna, Rebekah APRN PCMH: No Kingstree, SC 29556 Provider ID: 1531819 (803) 316-9056 Gender: Female Licensed Professional Counselor Fax: (803) 774-4378 Es Pediatric Partners LLC Mon - Fri 9:00 to 5:00 402 Nelson Blvd, Ste 100 Fulton, Melissa LPC PCMH: No Kingstree, SC 29556 Provider ID: 1241482 (843) 401-4200 Gender: Female Nurse Practitioner Fax: (843) 833-8599 Devine Destiny Counseling And Mon - Fri 8:30 to 5:00 Consu Gulledge, Paul ARNP PCMH: No 215 N Jackson St Provider ID: 2207669 Kingstree, SC 29556-3319 Gender: Male (843) 264-6400 Mcleod Family Medicine Kingstree Speech Therapy Mon - Fri 9:00 to 5:00 512 Nelson Blvd, Ste 200 Holmes, Essie SLP PCMH: No Kingstree, SC 29556-4027 Provider ID: 770957 (843) 355-5459 Gender: Female Gamble, Natalie LPC Fax: (843) 355-9704 Williamsburg Speech Language Provider ID: 1714266 Mon - Thu 8:00 to 5:00 Therap Gender: Female Fri 8:00 to 12:00 1253 Gausetown Rd Hopehealth Kingstree PCMH: No Kingstree, SC 29556-7491 520 Thurgood Marshall Hwy, Ste B (843) 372-4275 Kingstree, SC 29556-4108 Fax: (843) 382-7651 (843) 355-5628 Mon - Fri 9:00 to 5:00 Fax: (843) 355-6072 PCMH: No Mon - Fri 7:30 to 5:00 PCMH: No

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 231 38642781

Pharmacy Chesterfield Retail P & H Pharmacy 700 Chesterfield Hwy CVS Pharmacy Cheraw, SC 29520 205 N Van Lingle Mungo Blvd (843) 537-3801 Pageland, SC 29728 Fax: (843) 537-0170 (843) 672-2420 Mon - Fri 9:00 to 6:00 Fax: (843) 672-5860 Sat 8:00 to 12:00 Mon - Fri 8:00 to 8:00 Sat 9:00 to 6:00 Pageland Family Pharmacy Sun 10:00 to 6:00 214 S Van Lingle Mungo Bl Pageland, SC 29728 CVS Pharmacy (843) 675-2323 901 Market St Fax: (843) 675-2025 Cheraw, SC 29520 Mon - Fri 9:00 to 6:00 (843) 537-9374 Sat 9:00 to 1:00 Fax: (843) 921-4377 Mon - Sat 9:00 to 9:00 Sandhills Medical Pharmacy Sun 10:00 to 6:00 645 S 7th St Mcbee, SC 29101 Chesterfield Drug Company (843) 335-8297 139 Main St Fax: (843) 335-8555 Chesterfield, SC 29709 Mon - Fri 8:30 to 6:00 (843) 623-2632 Fax: (843) 623-6031 Walmart Pharmacy Mon - Fri 8:00 to 7:00 1040 Chesterfield Hwy 10 Sat 8:30 to 1:00 Cheraw, SC 29520 (843) 537-2741 Csc Community Pharmacy Fax: (843) 537-2743 715 S Doctors Dr Suite A Mon - Fri 9:00 to 9:00 Cheraw, SC 29520 Sat 9:00 to 6:00 (843) 865-4080 Sun 10:00 to 5:00 Fax: (843) 865-4085 Languages: Spanish Wannamaker Drug Mon - Fri 8:30 to 6:00 107 West Blvd Chesterfield, SC 29709 Harseys Pharmacy (843) 623-2999 280 Us Hwy 1 South Fax: (843) 623-3615 Cheraw, SC 29520 Mon - Fri 9:00 to 6:00 (843) 537-9991 Sat 9:00 to 12:00 Fax: (843) 537-5081 Mon - Fri 9:00 to 6:00 Wannamakers Drug Store Sat 9:00 to 1:00 154 Market St Cheraw, SC 29520 Jefferson Drug (843) 537-3221 409 E Church St Fax: (843) 537-9550 Jefferson, SC 29718 Mon - Fri 9:00 to 6:00 (843) 658-3006 Sat 9:00 to 12:00 Fax: (843) 658-7811 Mon - Fri 8:30 to 5:30

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 232 38642781

Pharmacy Darlington Retail Hartsville Drug Company Inc Walmart Pharmacy 134 W Carolina Ave 1150 S 4th St CVS Pharmacy Hartsville, SC 29550 Hartsville, SC 29550 102 Express Ln (843) 332-6581 (843) 332-8111 Darlington, SC 29532 Fax: (843) 332-7783 Fax: (843) 383-4667 (843) 395-6448 Mon - Fri 9:00 to 6:00 Mon - Fri 9:00 to 9:00 Fax: (843) 393-3525 Sat 9:00 to 12:00 Sat 9:00 to 7:00 Mon - Fri 9:00 to 8:00 Sun 10:00 to 6:00 Sat 9:00 to 6:00 Lamar Family Pharmacy Sun 10:00 to 6:00 100 N Railroad Ave Lamar, SC 29069 CVS Pharmacy (843) 326-5231 2310 W Bobo Newsom Hwy Fax: (843) 326-5068 Hartsville, SC 29550 Mon - Fri 9:00 to 6:00 (843) 332-4191 Sat 9:00 to 1:00 Fax: (843) 383-2231 Sun 12:00 to 12:00 Mon - Fri 8:00 to 9:00 Sat 9:00 to 6:00 Nursing Home Dispensary Sun 10:00 to 6:00 212 W Carolina Ave Hartsville, SC 29550 Carolina Drug Store Inc (843) 332-5193 52 Public Sq Fax: (843) 332-2589 Darlington, SC 29532 Mon - Fri 9:00 to 6:00 (843) 393-2865 Fax: (843) 393-4445 Palmetto Breathing Solutions Mon - Fri 9:00 to 6:00 18 Public Square Darlington, SC 29532 Csc Community Pharmacy (843) 393-1001 1280 S 4th St Fax: (843) 398-0020 Hartsville, SC 29550 Mon - Fri 8:00 to 5:00 (843) 339-5530 Fax: (843) 339-5531 Professional Pharmacy Languages: Spanish 201 Cashua St Ste 2 Mon - Fri 8:30 to 6:00 Darlington, SC 29532 (843) 393-6591 Csc Community Fax: (843) 395-8449 Pharmacy-Society Hill Languages: Spanish 743 S Main St Mon - Thu 8:00 to 6:00 Society Hill, SC 29593 Fri 8:00 to 5:30 (843) 378-4148 Fax: (843) 378-1144 Walmart Pharmacy Languages: Spanish 251 Andover Pl Mon - Fri 8:30 to 6:00 Darlington, SC 29532 (843) 395-8467 Darlington Family Pharmacy Fax: (843) 395-8469 203 S Main St Mon - Fri 9:00 to 9:00 Darlington, SC 29532 Sat 9:00 to 7:00 (843) 395-6020 Sun 10:00 to 6:00 Fax: (843) 395-2595 Languages: Spanish Mon - Fri 9:00 to 6:00 Sat 9:00 to 12:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 233 38642781

Pharmacy Dillon Retail Walmart Pharmacy 805 Enterprise Rd CVS Pharmacy Dillon, SC 29536 1211 Highway 301 N (843) 841-2228 Dillon, SC 29536 Fax: (843) 841-2331 (843) 774-5616 Mon - Fri 9:00 to 9:00 Fax: (843) 774-0730 Sat 9:00 to 7:00 Mon - Fri 8:00 to 8:00 Sun 10:00 to 6:00 Sat 9:00 to 6:00 Sun 10:00 to 6:00

Central Pharmacy 303 N Main St Lake View, SC 29563 (843) 759-2800 Fax: (843) 759-9974 Mon - Fri 9:00 to 5:30 Csc Community Pharmacy-Latta 122 Latimer St Latta, SC 29565 (843) 627-6261 Fax: (843) 627-6265 Languages: Spanish Mon - Fri 8:30 to 6:00

Dillon Community Pharmacy 200 W Harrison St Ste A Dillon, SC 29536 (843) 774-4749 Fax: (843) 627-0077 Mon - Fri 9:00 to 6:00 Sat 9:00 to 12:00

Dillon Family Pharmacy 603 N 6th Ave Dillon, SC 29536 (843) 774-1816 Fax: (843) 774-1833 Mon - Thu 8:00 to 5:30 Fri 8:00 to 4:30

Latta Drug Co Inc 106 E Main St Latta, SC 29565 (843) 752-0023 Fax: (843) 752-0062 Mon - Sat 9:00 to 6:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 234 38642781

Pharmacy Florence Retail CVS Pharmacy Lowcountry Pharmacy LLC 301 W Thomas St 1530 Mcclure Court Advantage Pharmacy And Lake City, SC 29560 Florence, SC 29505 Wellness (843) 394-5434 (843) 656-2973 506 W Palmetto St Fax: (843) 394-3654 Fax: (843) 656-2978 Florence, SC 29501 Mon - Fri 8:00 to 9:00 Mon - Fri 9:00 to 5:30 (843) 407-7637 Sat 9:00 to 6:00 Fax: (843) 669-1054 Sun 10:00 to 6:00 M & D Drug Company Mon - Fri 8:00 to 6:00 117 E Main St CVS Pharmacy Lake City, SC 29560 CVS Pharmacy 3306 W Palmetto St (843) 374-3711 3210 E Palmetto St Florence, SC 29501 Fax: (843) 374-8925 Florence, SC 29506 (843) 317-9365 Mon - Fri 8:00 to 5:00 (843) 662-3740 Fax: (843) 629-8213 Sat 8:00 to 12:00 Fax: (843) 665-4734 Mon - Fri 8:00 to 9:00 Mon - Fri 9:00 to 8:00 Sat 9:00 to 6:00 Mcleod Outpatient Pharmacy Sat 9:00 to 6:00 Sun 10:00 to 6:00 501 E Cheves St Ste D Sun 10:00 to 6:00 Florence, SC 29506 Careplusrx Pharmacy (843) 777-2166 CVS Pharmacy 822 Pamplico Hwy Fax: (843) 777-2950 2501 2nd Loop Rd Florence, SC 29505 Mon - Fri 7:00 to 8:00 Florence, SC 29501 (843) 799-1211 Sat 9:00 to 1:00 (843) 667-0134 Fax: (843) 799-1217 Fax: (843) 317-9653 Languages: Hindi Medicine Mart Mon - Fri 9:00 to 8:00 Mon - Fri 9:00 to 7:00 1337 S Irby St Sat - Sun 10:00 to 6:00 Sat 9:00 to 1:00 Florence, SC 29505 Sun 12:00 to 12:00 (843) 667-0759 CVS Pharmacy Fax: (843) 667-0506 800 Pamplico Hwy F & L Drug Store Mon - Fri 9:30 to 6:00 Florence, SC 29505 223 N Jones Rd Sat 9:30 to 1:00 (843) 292-0621 Olanta, SC 29114 Fax: (843) 292-0627 (843) 396-4431 Omnicare Of Florence Mon - Fri 8:00 to 9:00 Fax: (843) 370-0013 3203 W Palmetto St Ste G Sat 9:00 to 6:00 Mon - Fri 9:00 to 6:00 Florence, SC 29501 Sun 10:00 to 6:00 Sat 9:00 to 1:00 (843) 665-8332 Fax: (803) 665-8618 CVS Pharmacy Kjs Pharmacy 129 Mon - Fri 8:00 to 7:30 733 S Irby St 240 Kelley St Sat 10:00 to 5:00 Florence, SC 29501 Lake City, SC 29560 (843) 665-4475 (843) 374-1110 Palmetto Prescription Center Fax: (843) 629-5482 Fax: (843) 374-1117 3198 W Palmetto St Mon - Sun 12:00 to 12:00 Mon - Fri 8:00 to 7:00 Florence, SC 29501 Sat 8:00 to 5:00 (843) 292-9783 CVS Pharmacy Fax: (843) 292-9784 2791 David H Mcleod Blvd Longs Drug Mon - Fri 9:00 to 6:00 Florence, SC 29501 Longs Drugs Sat 9:00 to 12:00 (843) 667-6891 360 N Irby St Fax: (843) 773-8747 Florence, SC 29501 Pamplico Pharmacy Mon - Fri 9:00 to 7:00 (843) 656-0390 616 S Walnut St Sat 9:00 to 6:00 Fax: (843) 667-9435 Pamplico, SC 29583 Sun 10:00 to 5:00 Mon - Fri 8:00 to 7:00 (843) 493-2311 Sat 9:00 to 2:00 Fax: (843) 493-3005 Languages: Spanish Mon - Fri 8:30 to 6:30 Sat 9:00 to 1:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 235 38642781

Pharmacy Florence Retail - cont. Vistara Pharmacy Walmart Pharmacy 817 S Cashua Dr Ste C 2014 S Irby St Piggly Wiggly Pharmacy Florence, SC 29501 Florence, SC 29505 1945 W Palmetto St Suite 32 (843) 713-1575 (843) 292-0307 Florence, SC 29501 Fax: (877) 839-0075 Fax: (843) 292-9582 (843) 673-9107 Languages: Hindi Mon - Fri 9:00 to 9:00 Fax: (843) 673-9109 Mon - Fri 9:00 to 6:00 Sat 9:00 to 7:00 Mon - Fri 9:00 to 6:00 Sun 10:00 to 6:00 Sat 9:00 to 1:00 Wall Drugs Of Johnsonville Inc 239 East Stuckey St Well Center Pharmacy Professional Pharmacy Of Olanta Johnsonville, SC 29555 605 S Irby St (843) 386-6135 Florence, SC 29501 211 S Jones Rd Ste A Fax: (843) 380-1025 (843) 799-5054 Olanta, SC 29114 Languages: Spanish Fax: (843) 799-5168 (843) 699-2009 Mon - Fri 8:00 to 6:00 Mon - Fri 9:00 to 6:00 Fax: (843) 395-8423 Sat 8:00 to 12:00 Sat 9:00 to 1:00 Mon - Wed 8:00 to 6:00 Thu 8:00 to 9:00 Fri 8:00 to 3:00 Wall Drugs Of Pamplico Inc 616 S Walnut St Pamplico, SC 29583 Sams Club Pharmacy (843) 905-0200 200 N Beltline Dr Fax: (843) 905-0201 Florence, SC 29501 Mon - Fri 9:00 to 6:00 (843) 758-6087 Sat - Sun 12:00 to 12:00 Fax: (843) 758-6088 Mon - Fri 9:00 to 7:00 Sat 9:00 to 6:00 Walmart Pharmacy 230 N Beltline Dr Florence, SC 29501 The Medicine Cabinet (843) 664-0909 319 Mercy St Fax: (843) 664-0911 Lake City, SC 29560 Mon - Fri 8:00 to 9:00 (843) 374-2825 Sat 8:00 to 7:00 Fax: (843) 374-9914 Sun 10:00 to 6:00 Mon - Fri 8:30 to 6:30 Sat 8:30 to 12:00 Walmart Pharmacy 900 Us 52 Hwy The Pharmacy Lake City, SC 29560 2500 Hoffmeyer Rd (843) 394-8125 Florence, SC 29501 Fax: (843) 394-8303 (843) 773-2821 Mon - Fri 9:00 to 9:00 Fax: (843) 773-2822 Sat 9:00 to 6:00 Mon - Fri 9:00 to 6:30 Sun 10:00 to 5:00 Sat 9:00 to 1:00 Walmart Pharmacy Timmonsville Pharmacy 804 S Cashua Dr 309 E Smith St Florence, SC 29501 Timmonsville, SC 29161 (843) 269-9980 (843) 346-5410 Fax: (843) 269-9981 Fax: (843) 346-5414 Mon - Fri 9:00 to 9:00 Languages: Spanish Sat 9:00 to 7:00 Mon - Fri 9:00 to 6:00 Sun 10:00 to 6:00 Sat 9:00 to 12:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 236 38642781

Pharmacy Horry Retail CVS Pharmacy CVS Pharmacy 140 Sayebrook Pkwy 4767 Broad St Atlantic Apothecary Myrtle Beach, SC 29588 Loris, SC 29569 3816 Hwy 17 S Ste 2 (843) 294-6572 (843) 716-1220 North Myrtle Beach, SC 29582 Fax: (843) 294-6572 Fax: (843) 716-1226 (843) 272-7900 Mon - Fri 9:00 to 7:00 Mon - Fri 8:00 to 9:00 Fax: (843) 272-5090 Sat 9:00 to 5:00 Sat 9:00 to 6:00 Mon - Fri 8:00 to 6:00 Sun 11:00 to 5:00 Sun 10:00 to 6:00 Sat 9:00 to 1:00 CVS Pharmacy CVS Pharmacy Aynor Family Pharmacy 930 82nd Pkwy 2996 E Highway 501 240 8th Avenue Myrtle Beach, SC 29572 Conway, SC 29526 Aynor, SC 29511 (843) 449-4751 (843) 347-2613 (843) 358-2000 Fax: (843) 449-8213 Fax: (843) 234-0402 Fax: (843) 358-2524 Mon - Fri 9:00 to 8:00 Mon - Fri 8:00 to 9:00 Mon - Fri 8:00 to 6:00 Sat - Sun 10:00 to 5:00 Sat 9:00 to 6:00 Sat 9:00 to 2:00 Sun 10:00 to 6:00 CVS Pharmacy CVS Pharmacy 101 Founders Bay Rd CVS Pharmacy 9718 N Kings Hwy Murrells Inlet, SC 29576 1150 Seaboard St Myrtle Beach, SC 29572 (843) 651-8863 Myrtle Beach, SC 29577 (843) 497-8625 Fax: (843) 651-8864 (843) 626-5034 Fax: (843) 497-8893 Mon - Fri 8:00 to 9:00 Fax: (843) 213-2892 Mon - Fri 9:00 to 7:00 Sat 9:00 to 6:00 Mon - Fri 9:00 to 7:00 Sat - Sun 10:00 to 6:00 Sun 10:00 to 6:00 Sat 9:00 to 5:00 Sun 11:00 to 5:00 CVS Pharmacy CVS Pharmacy 512 S Kings Hwy 2492 Highway 9 E CVS Pharmacy Myrtle Beach, SC 29577 Little River, SC 29566 6617 N Kings Hwy (843) 448-1684 (843) 399-1726 Myrtle Beach, SC 29572 Fax: (843) 916-4344 Fax: (843) 399-8497 (843) 449-5246 Mon - Fri 9:00 to 8:00 Mon - Fri 8:00 to 9:00 Fax: (843) 692-2766 Sat 9:00 to 6:00 Sat 9:00 to 6:00 Mon - Fri 9:00 to 8:00 Sun 10:00 to 6:00 Sun 10:00 to 6:00 Sat 9:00 to 6:00 Sun 10:00 to 6:00 CVS Pharmacy CVS Pharmacy 1010 Highway 17 N 578 International Dr CVS Pharmacy North Myrtle Beach, SC 29582 Myrtle Beach, SC 29579 101 Fetlock Dr (843) 249-1451 (843) 903-0444 Myrtle Beach, SC 29588 Fax: (843) 280-7931 Fax: (843) 996-1409 (843) 236-6300 Mon - Fri 8:00 to 9:00 Mon - Fri 8:00 to 9:00 Fax: (843) 236-6335 Sat 9:00 to 6:00 Sat 9:00 to 6:00 Mon - Fri 9:00 to 8:00 Sun 10:00 to 6:00 Sun 10:00 to 6:00 Sat - Sun 10:00 to 6:00

CVS Pharmacy CVS Pharmacy CVS Pharmacy 1370 Highway 17 1303 38th Ave N 707 Church St Little River, SC 29566 Myrtle Beach, SC 29577 Conway, SC 29526 (843) 249-7618 (843) 448-4437 (843) 248-6302 Fax: (843) 249-3248 Fax: (843) 946-9677 Fax: (843) 248-0752 Mon - Fri 8:00 to 8:00 Mon - Sun 12:00 to 12:00 Mon - Fri 8:00 to 9:00 Sat 9:00 to 6:00 Sat 8:00 to 6:00 Sun 10:00 to 6:00 Sun 10:00 to 6:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 237 38642781

Pharmacy Horry Retail - cont. Coastal Cancer Center Pharmacy Kroger Drugstore 2939 S Highway 17 CVS Pharmacy 8121 Rourk St Murrells Inlt, SC 29576 3411 Socastee Blvd Myrtle Beach, SC 29572 (843) 357-4300 Myrtle Beach, SC 29588 (843) 692-5000 Fax: (843) 357-2480 (843) 294-1285 Fax: (833) 287-1231 Mon - Fri 9:00 to 9:00 Fax: (843) 294-1291 Languages: Spanish Sat 10:00 to 4:00 Mon - Fri 8:00 to 9:00 Mon - Fri 7:30 to 4:30 Sun 12:00 to 5:00 Sat 9:00 to 6:00 Sun 10:00 to 6:00 Conway Pharmacy Kroger Pharmacy 1610 Church St Ste C 781 Main St CVS Pharmacy Conway, SC 29526 N Myrtle Bch, SC 29582 4401 Highway 17 S (843) 488-3535 (843) 249-9967 North Myrtle Beach, SC 29582 Fax: (843) 488-3435 Fax: (843) 280-3643 (843) 272-8884 Languages: Arabic Mon - Fri 9:00 to 9:00 Fax: (843) 272-3314 Mon - Fri 9:00 to 6:00 Sat 10:00 to 4:00 Mon - Fri 9:00 to 8:00 Sat 9:00 to 2:00 Sun 12:00 to 5:00 Sat - Sun 10:00 to 5:00 Sun 12:00 to 12:00 Kroger Sav-On CVS Pharmacy Costco Pharmacies 9610 N Kings Hwy 601 Highway 17 N Costco Pharmacy Myrtle Beach, SC 29572 Surfside Beach, SC 29575 1021 Oak Forest Ln (843) 449-2158 (843) 238-5628 Myrtle Beach, SC 29577 Fax: (843) 692-7221 Fax: (843) 232-0320 (843) 839-6606 Mon - Fri 9:00 to 9:00 Mon - Fri 8:00 to 8:00 Fax: (843) 839-6632 Sat 10:00 to 4:00 Sat 9:00 to 6:00 Mon - Fri 10:00 to 7:00 Sun 12:00 to 5:00 Sun 10:00 to 6:00 Sat 9:30 to 6:00 Little River Medical Ctr Phcy Carolina Forest Pharmacy Golden Town Pharmacy 4303 Live Oak Dr 4036 River Oaks Dr Unit B1 2837 Highway 501 East Little River, SC 29566 Myrtle Beach, SC 29579 Aynor, SC 29511 (843) 663-8099 (843) 236-6500 (843) 358-7777 Fax: (843) 281-8454 Fax: (843) 584-8534 Fax: (843) 358-7775 Languages: Spanish Languages: Arabic Languages: Spanish Mon - Fri 9:00 to 5:30 Mon - Fri 9:00 to 6:00 Mon - Fri 9:00 to 6:00 Sat 9:00 to 1:00 Sat 9:00 to 1:00 Little River Medical Ctr Phcy 4220 Carolina Exchange Dr Carolina Health Pharmacy Healthcare Partners Of Sc Myrtle Beach, SC 29579 5405 Dick Pond Rd 1608 N Main St (843) 663-8051 Myrtle Beach, SC 29588 Conway, SC 29526 Fax: (843) 663-8382 (843) 215-8200 (843) 488-6341 Mon - Fri 9:00 to 5:00 Fax: (843) 507-8733 Fax: (843) 488-6346 Languages: Arabic Mon - Fri 8:00 to 5:00 Loris Drug Store Mon - Fri 9:00 to 6:00 4125 Main St Sat 9:00 to 1:00 Kroger Drugstore Loris, SC 29569 3735 Renee Dr (843) 756-4021 Cherry Grove Drug Myrtle Beach, SC 29579 Fax: (843) 756-9124 1201 Sea Mountain Highway (843) 236-4296 Mon - Sun 12:00 to 12:00 North Myrtle Beach, SC 29582 Fax: (843) 236-4274 (843) 361-3784 Mon - Fri 9:00 to 9:00 Mcleod Choice Phcy Seacoast Fax: (843) 361-3785 Sat 10:00 to 4:00 4000 Hwy 9 East Mon - Fri 9:00 to 6:00 Sun 12:00 to 5:00 Little River, SC 29566 Sat 9:00 to 1:00 (843) 366-3107 Fax: (843) 366-3108 Mon - Fri 8:00 to 5:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 238 38642781

Pharmacy Horry Retail - cont. Publix Super Markets The Medicine Shoppe Publix Pharmacy 3985 Meeting St Medicine Mart 7925 N Kings Hwy Loris, SC 29569 1401 Main St Myrtle Beach, SC 29572 (843) 756-1600 Conway, SC 29526 (843) 449-1620 Fax: (843) 756-3382 (843) 248-4609 Fax: (843) 492-4278 Mon - Fri 8:30 to 6:00 Fax: (843) 488-0770 Mon - Fri 9:00 to 9:00 Sat 8:30 to 1:00 Mon - Fri 8:00 to 6:00 Sat 9:00 to 7:00 Sat 8:00 to 12:00 Sun 11:00 to 6:00 The Pharmacy At Cmc 300 Singleton Ridge Rd Nyes Pharmacy Publix Super Markets Conway, SC 29526 1600 10th Ave Publix Pharmacy (843) 347-8123 Conway, SC 29526 1576 Highway 17 N Fax: (843) 349-0862 (843) 248-5015 North Myrtle Beach, SC 29582 Mon - Fri 9:00 to 5:00 Fax: (843) 488-1942 (843) 272-0059 Languages: Spanish Fax: (843) 491-6911 Walgreens Drug Store Mon - Fri 8:00 to 6:00 Mon - Fri 9:00 to 9:00 Walgreens Sat 8:00 to 2:00 Sat 9:00 to 7:00 1905 Highway 544 Sun 11:00 to 6:00 Conway, SC 29526 Ocean Lakes Pharmacy (843) 347-7617 1415 Highway 17 N Rivertown Pharmacy Inc Fax: (843) 234-0898 Surfside Beach, SC 29575 2000 Main St Mon - Fri 9:00 to 9:00 (843) 238-5159 Conway, SC 29526 Sat 9:00 to 6:00 Fax: (843) 238-8270 (843) 488-4400 Sun 10:00 to 6:00 Mon - Fri 9:00 to 6:00 Fax: (843) 488-4401 Sat 9:00 to 2:00 Mon - Fri 8:30 to 6:00 Walgreens Drug Store Sat 9:00 to 2:00 Walgreens Publix Super Markets 7800 N Kings Hwy Publix Pharmacy Sams Club Pharmacy Myrtle Beach, SC 29572 11920 Highway 707 Ste A 1946 10th Ave N (843) 497-9995 Murrells Inlet, SC 29576 Myrtle Beach, SC 29577 Fax: (843) 497-9592 (843) 353-5614 (843) 445-7179 Mon - Fri 9:00 to 9:00 Fax: (843) 806-4777 Fax: (843) 445-7596 Sat 9:00 to 6:00 Mon - Fri 9:00 to 9:00 Mon - Fri 9:00 to 7:00 Sun 10:00 to 6:00 Sat 9:00 to 7:00 Sat 9:00 to 6:00 Sun 11:00 to 6:00 Walgreens Drug Store Seashore Drugs Walgreens Publix Super Markets 1304 Highway 17 5001 Socastee Blvd Publix Pharmacy Little River, SC 29566 Myrtle Beach, SC 29588 2170 Oakheart Rd (843) 281-9797 (843) 293-6066 Myrtle Beach, SC 29579 Fax: (843) 281-9771 Fax: (843) 293-6238 (843) 903-4615 Mon - Fri 9:00 to 6:00 Mon - Fri 7:00 to 12:00 Fax: (843) 492-5492 Sat 9:00 to 12:00 Sat 8:00 to 10:00 Mon - Fri 9:00 to 9:00 Sun 9:00 to 10:00 Sat 9:00 to 7:00 Sherrys Meds And More Sun 11:00 to 6:00 Pharmacy Walgreens Drug Store 3914 Main St Walgreens Loris, SC 29569 600 Hwy 17 S (843) 756-4664 North Myrtle Beach, SC 29582 Fax: (843) 756-4668 (843) 272-4269 Mon - Fri 8:30 to 6:00 Fax: (843) 361-1435 Sat 8:30 to 1:00 Mon - Fri 9:00 to 9:00 Sat 9:00 to 6:00 Sun 10:00 to 6:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 239 38642781

Pharmacy Horry Retail - cont. Walmart Pharmacy Waterway Pharmacy 541 Seaboard St 3373 Highway 9 E Walmart Pharmacy Myrtle Beach, SC 29577 Little River, SC 29566 550 Highway 17 N (843) 445-7851 (843) 734-0612 North Myrtle Beach, SC 29582 Fax: (843) 445-7953 Fax: (843) 734-0793 (843) 281-8176 Mon - Fri 9:00 to 9:00 Languages: Hindi Fax: (843) 281-8309 Sat 9:00 to 6:00 Mon - Fri 9:00 to 6:00 Mon - Fri 9:00 to 9:00 Sun 10:00 to 5:00 Sat 9:00 to 2:00 Sat 9:00 to 7:00 Sun 10:00 to 6:00 Walmart Pharmacy 125 Maryport Dr Walmart Pharmacy Myrtle Beach, SC 29575 545 Garden City Connector (843) 232-0495 Murrells Inlet, SC 29576 Fax: (843) 232-0497 (843) 357-6588 Mon - Fri 9:00 to 9:00 Fax: (843) 357-6591 Sat 9:00 to 7:00 Mon - Fri 9:00 to 9:00 Sun 10:00 to 6:00 Sat 9:00 to 6:00 Sun 10:00 to 5:00 Walmart Pharmacy 3650 Walton Dr Walmart Pharmacy Myrtle Beach, SC 29577 3915 North Kings Hwy (843) 839-9875 Myrtle Beach, SC 29577 Fax: (843) 839-9867 (843) 353-5589 Mon - Fri 9:00 to 9:00 Fax: (843) 353-5588 Sat 9:00 to 7:00 Mon - Fri 9:00 to 9:00 Sun 10:00 to 6:00 Sat 9:00 to 7:00 Sun 10:00 to 6:00 Walmart Pharmacy 11980 Highway 17 Byp Walmart Pharmacy Murrells Inlet, SC 29576 151 Myrtle Ridge Dr (843) 357-2000 Conway, SC 29526 Fax: (843) 357-2080 (843) 234-1420 Mon - Fri 8:00 to 9:00 Fax: (843) 234-1440 Sat 9:00 to 7:00 Mon - Fri 9:00 to 9:00 Sun 10:00 to 6:00 Sat 9:00 to 6:00 Sun 10:00 to 6:00 Walmart Pharmacy 10820 Kings Rd Walmart Pharmacy Myrtle Beach, SC 29572 2709 Church St Ste A (843) 449-0508 Conway, SC 29526 Fax: (843) 692-8936 (843) 365-0301 Mon - Fri 9:00 to 7:00 Fax: (843) 365-0318 Sat 9:00 to 6:00 Mon - Fri 8:00 to 9:00 Sun 10:00 to 5:00 Sat 9:00 to 7:00 Sun 10:00 to 6:00 Walmart Pharmacy 1705 S Kings Hwy Walmart Pharmacy Myrtle Beach, SC 29577 2751 Beaver Run Blvd (843) 353-5640 Myrtle Beach, SC 29575 Fax: (843) 353-5639 (843) 215-3856 Mon - Fri 9:00 to 9:00 Fax: (843) 215-3859 Sat 9:00 to 7:00 Mon - Fri 9:00 to 9:00 Sun 10:00 to 6:00 Sat 10:00 to 6:00 Sun 9:00 to 7:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 240 38642781

Pharmacy Marion Retail Walmart Pharmacy 305 Commerce Dr Bridgers Drug Store Mullins, SC 29574 305 N Main St (843) 423-9411 Marion, SC 29571 Fax: (843) 423-7510 (843) 423-2682 Mon - Fri 9:00 to 9:00 Fax: (843) 423-2429 Sat 9:00 to 7:00 Mon - Fri 8:30 to 5:30 Sun 10:00 to 6:00 Sat 8:30 to 12:00

CVS Pharmacy 236 W Mcintyre St Mullins, SC 29574 (843) 464-0372 Fax: (843) 464-2729 Mon - Fri 8:00 to 8:00 Sat 9:00 to 6:00 Sun 10:00 to 6:00

CVS Pharmacy 700 N Main St Marion, SC 29571 (843) 423-1021 Fax: (843) 423-2178 Mon - Fri 8:00 to 9:00 Sat 9:00 to 6:00 Sun 10:00 to 6:00

Carolina Pharmacy 2537 E Highway 76 Ste B Marion, SC 29571 (843) 765-3320 Fax: (843) 765-3321 Mon - Fri 9:00 to 6:00 Sat 9:00 to 12:00 Sun 12:00 to 12:00 Health Care Partners Phcy Marion 145 Palmetto Pointe Road Marion, SC 29571 (843) 765-4240 Fax: (843) 874-5100 Languages: Spanish Mon - Fri 9:00 to 5:00 Sat - Sun 12:00 to 12:00

Mullins Discount Drug 310 S Main St Mullins, SC 29574 (843) 464-1757 Fax: (843) 464-1751 Languages: Spanish Mon - Sun 12:00 to 12:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 241 38642781

Pharmacy Marlboro Retail Walmart Pharmacy 336 Highway 9 W CVS Pharmacy Bennettsville, SC 29512 1085 Cottingham Blvd N Ste 3 (843) 479-0029 Bennettsville, SC 29512 Fax: (843) 479-0031 (843) 479-8355 Mon - Fri 9:00 to 9:00 Fax: (843) 479-9782 Sat 9:00 to 6:00 Mon - Fri 9:00 to 8:00 Sun 10:00 to 6:00 Sat - Sun 10:00 to 6:00 Csc Community Pharmacy Mccoll 3080 Highway 15 401 E Mc Coll, SC 29570 (843) 523-6212 Fax: (843) 523-6216 Languages: Spanish Mon - Fri 9:00 to 6:00 Csc Community Phcy Bennetts- ville 999 Cheraw St Bennettsville, SC 29512 (843) 456-7777 Fax: (843) 456-7778 Languages: Spanish Mon - Fri 8:30 to 6:00

Fowler Pharmacy 301 E Market St Bennettsville, SC 29512 (843) 479-3831 Fax: (843) 479-1376 Mon - Tue, Thu - Fri 9:00 to 6:00 Wed 9:00 to 5:00

Marlboro Drug Company 113 N Marlboro St Bennettsville, SC 29512 (843) 479-4248 Fax: (843) 479-3640 Mon - Fri 9:00 to 6:00

Medcare Pharmacy 1114 Cottingham Blvd N Ste B Bennettsville, SC 29512 (843) 479-7101 Fax: (843) 479-7101 Languages: Spanish Mon - Fri 8:00 to 6:00 Sat 9:00 to 1:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 242 38642781

Pharmacy Williamsburg Retail Black River Pharmacy 32a N Williamsburg County Hwy Kingstree, SC 29556 (843) 355-5656 Fax: (843) 355-5655 Mon - Fri 9:00 to 6:00 Sat 9:00 to 1:00

CVS Pharmacy 120 N Longstreet St Kingstree, SC 29556 (843) 354-5565 Fax: (843) 354-3735 Mon - Fri 9:00 to 8:00 Sat 9:00 to 6:00 Sun 10:00 to 6:00

CVS Pharmacy 206 S Main St Hemingway, SC 29554 (843) 558-9455 Fax: (843) 558-7614 Mon - Fri 9:00 to 8:00 Sat 9:00 to 6:00 Sun 10:00 to 6:00

Greeleyville Pharmacy 215 Varner Ave Greeleyville, SC 29056 (843) 426-2170 Fax: (843) 426-2166 Mon - Fri 9:00 to 6:00 Sat 9:00 to 12:00

Stuckey Pharmacy 207 South Main St Hemingway, SC 29554 (843) 558-1010 Fax: (843) 558-1014 Mon - Fri 9:00 to 6:00 Sat 9:00 to 12:00

Williamsburg Pharmacy 411 Thurgood Marshall Blvd Kingstree, SC 29556 (843) 355-3300 Fax: (843) 355-3302 Mon - Fri 9:00 to 6:00 Sat 9:00 to 1:00

This directory is updated as of 02/03/2021. www.wellcare.com/South-Carolina | 243 38642781

Alternate Languages Index You can find a provider who speaks a different language in this index. First look for the language you need. Then check the specialty and provider name. Indice de idiomas alternativos: En este índice, usted puede encontrar un proveedor que hable otro idioma. Primero busque el idioma que necesita, y luego verifique la especialidad y el nombre del proveedor.

American Sign Language Federally Qualified Health Gujarati Center Convenient Care Clinic Gastroenterology Biester, Christina MD ...... 134 Minuteclinic LLC ...... 142 Oza, Veeral MD ...... 50 French Arabic Internal Medicine Family Practice Gastroenterology Shah, Vipul MD ...... 55 Macdonald, Allan MD ...... 8 Charbel, Samer MD ...... 87 Preventive Medicine Gastroenterology Internal Medicine Leisy, Heather MD ...... 73 Charbel, Samer MD ...... 87 Hassan, Alkhatib MD ...... 95 Psychology Itani, Najla MD ...... 96 Internal Medicine Hunter, William PSYD ...... 74 Itani, Najla MD ...... 96 Nephrology Hindi Alsaka, Mhd MD ...... 57 Nephrology Cardiology Alsaka, Mhd MD ...... 57 Ophthalmology Pande, Amit MD ...... 83 Stokes, Mark MD ...... 66 Orthopaedic Surgery Gastroenterology Deshmukh, Ashwin MD ...... 70 Pulmonary Disease Oza, Veeral MD ...... 50 Hayek, Hafez MD ...... 113 Pediatrics Pannu, Davinderbir MD ...... 50 Japitana, Marian MD ...... 4 Retail Hematology & Oncology Carolina Forest Pharmacy ...... 238 Plastic & Reconstructive Surgery Thumallapally, Nishitha MD ...... 93 Carolina Health Pharmacy ...... 238 White, Steven MD ...... 111 Infectious Disease Conway Pharmacy ...... 238 Preventive Medicine Bharadwaj, Ramesh MD ...... 53 Leisy, Heather MD ...... 73 Chinese Internal Medicine Substance Abuse Pulmonary Disease Govindappa, Venugopal MD ...... 54 Kirkland, Marion LPC ...... 178 Elya, Marwan MD ...... 75 Shah, Vipul MD ...... 55 Hayek, Hafez MD ...... 113 Dutch Nephrology Family Practice German Govindappa, Venugopal MD ...... 57 Biester, Christina MD ...... 27 Vascular Surgery Obstetrics/Gynecology Winkler, Gabor MD ...... 120 Chaudhry, Anu MD ...... 63

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Alternate Languages Index Hindi - cont. Portuguese Wilson, Beverly APRN ...... 185 Licensed Professional Counselor Faiyaz, Seema MD ...... 43 General Surgery Lobo, Vanessa LPC ...... 165 Physician Assistant Poole, Trevor MD ...... 91 Neurology Tohid, Usman PA ...... 176 Internal Medicine Sandoz, George MD ...... 100 Psychology Santiago, Kenneth MD ...... 97 Hunter, William PSYD ...... 74 Ophthalmology Taype Perez De Roberts, Carmen Sandoz, George MD ...... 104 MD ...... 55 Pulmonary Disease Laboratory Pathology Testing Jona, Vinod MD ...... 75 Punjabi Laboratory Corp Of America ....151 Gastroenterology Retail Pannu, Davinderbir MD ...... 50 Licensed Professional Counselor Careplusrx Pharmacy ...... 235 Cantley, Amy LMHC ...... 191 Vistara Pharmacy ...... 236 Physician Assistant Lobo, Vanessa LPC ...... 165 Waterway Pharmacy ...... 240 Tohid, Usman PA ...... 176 Teague, Allen LPC ...... 194 Substance Abuse Russian Neurology Kirkland, Marion LPC ...... 178 Vascular Surgery Sandoz, George MD ...... 100 Winkler, Gabor MD ...... 120 Hungarian Nurse Practitioner Pediatrics Spanish Felder, Melissa APRN ...... 168 Schultz, Agnes MD ...... 1 Behavioral Health Facility Niederwerfer, Robin APRN ...... 199 Vascular Surgery Kershaw County Commission On Obstetrics/Gynecology Alcohol And ...... 134 Winkler, Gabor MD ...... 120 Faiyaz, Seema MD ...... 43 Ear Nose & Throat Levenson, Terry MD ...... 22 Ilocano Bondy, Peter MD ...... 85 Lineback, Bradley MD ...... 22 Physical Therapy Sutton, Darin MD ...... 86 Martinez, Eduardo MD ...... 102 Baslot, Joel PT ...... 227 Sto Domingo, Judie PT ...... 229 Endocrinology Diabetes Meta- Ophthalmology bolism Greene, Howard MD ...... 65 Mandarin Culleton, John MD ...... 48 Sandoz, George MD ...... 104 Rheumatology Family Practice Lee, Wendy MD ...... 114 Optometry Eaton, Carol PA ...... 181 Merhi, Eva OD ...... 106 Marathi Mattheis, John MD ...... 8 Vaught, James OD ...... 107 Cardiology Mendez, Luz MD ...... 3 Orthopaedic Surgery Pande, Amit MD ...... 83 Wilson, Beverly APRN ...... 181 Deshmukh, Ashwin MD ...... 70 Federally Qualified Health Center Teague, Allen LPC ...... 184

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Alternate Languages Index Spanish - cont. Substance Abuse Orthotics & Prosthetics Kirkland, Marion LPC ...... 178 Floyd Brace Company Inc ...... 147 Tagalog Pediatrics Hematology & Oncology Morphis, Elizabeth MD ...... 5 Lu, Rommel MD ...... 53 Nichols, William MD ...... 23 Obstetrics/Gynecology Preventive Medicine Schindler, Joycelyn MD ...... 103 Leisy, Heather MD ...... 73 Tamil Psychiatry Gastroenterology Bauer, Robert MD ...... 73 Ansari, Shoukath MD ...... 49

Psychology Ophthalmology Hunter, William PSYD ...... 74 Vasuki, Nagavivek MD ...... 67 Retail Telugu Coastal Cancer Center Pharmacy 238 Family Practice Csc Community Pharmacy Mccoll Beeraka, Prakash MD ...... 13 242 Hematology & Oncology Csc Community Pharmacy ...... 233 Thumallapally, Nishitha MD ...... 93 Csc Community Pharmacy-Latta 234 Urdu Csc Community Pharmacy-Society Hill ...... 233 Gastroenterology Csc Community Phcy Bennetts- Oza, Veeral MD ...... 50 ville ...... 242 Physician Assistant Darlington Family Pharmacy ..... 233 Tohid, Usman PA ...... 176 Golden Town Pharmacy ...... 238 Health Care Partners Phcy Marion Yoruba 241 Psychiatry Little River Medical Ctr Phcy ...238 Oduwole, Adedapo MD ...... 112 Medcare Pharmacy ...... 242 Mullins Discount Drug ...... 241 Nyes Pharmacy ...... 239 Pamplico Pharmacy ...... 235 Professional Pharmacy ...... 233 Timmonsville Pharmacy ...... 236 Wall Drugs Of Johnsonville Inc 236

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Specialty Providers At-A-Glance You can find a specific kind of provider in this index. First look for the type of care you need. Then check the county and page number. You can go to that page to get the provider’s information. Un vistazo a los proveedores especializados: En este índice, usted puede encontrar un tipo específico de proveedor. Primero busque el tipo de cuidado que necesita, y luego verifique el condado y el número de página. Consulte esa página para obtener la información del proveedor.

A Marion ...... 149 Horry ...... 181 Marlboro ...... 150 Marlboro ...... 228 Addiction Psychiatry Williamsburg ...... 151 Horry ...... 81 Colon & Rectal Surgery Horry ...... 84 Advance Registered Nurse Prac- C titioner Psychiatrist Cardiac Electrophysiology Community Health Center Horry ...... 179 Darlington ...... 30 Chesterfield ...... 134 Florence ...... 45 Darlington ...... 135 Advanced Practice Registered Horry ...... 179 Dillon ...... 136 Nurse Florence ...... 137 Horry ...... 179 Cardiology Horry ...... 141 Darlington ...... 30 Marion ...... 149 Allergy & Immunology Florence ...... 160 Marlboro ...... 150 Darlington ...... 30 Horry ...... 179 Williamsburg ...... 151 Florence ...... 45 Marion ...... 121 Horry ...... 81 Williamsburg ...... 124 Community Mental Health Williamsburg ...... 124 Center Cardiovascular Surgery Darlington ...... 135 Ambulatory Surgery Center Horry ...... 83 Florence ...... 137 Florence ...... 137 Horry ...... 141 Certified Nurse Anesthetist Horry ...... 141 Dillon ...... 158 Marion ...... 149 Audiology Florence ...... 161 Marlboro ...... 150 Darlington ...... 153 Horry ...... 180 Williamsburg ...... 151 Florence ...... 160 Horry ...... 179 Certified Nurse Midwife Convenient Care Clinic Horry ...... 180 Horry ...... 142 B Chiropractic D Behavioral Health Counseling Darlington ...... 30 Florence ...... 160 Dermatology Dillon ...... 38 Horry ...... 85 Behavioral Health Facility Florence ...... 47 Chesterfield ...... 134 Horry ...... 84 Diagnostic Center Darlington ...... 135 Marion ...... 121 Florence ...... 137 Dillon ...... 136 Horry ...... 142 Clinical Social Work Florence ...... 137 Florence ...... 162 Horry ...... 141

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Specialty Providers At-A-Glance D - cont. Marlboro ...... 228 Horry ...... 146 Williamsburg ...... 231 Diagnostic Imaging Hospital Florence ...... 138 Federally Qualified Health Chesterfield ...... 126 Horry ...... 143 Center Darlington ...... 127 Chesterfield ...... 134 Dillon ...... 128 Dialysis Darlington ...... 153 Florence ...... 129 Chesterfield ...... 134 Florence ...... 162 Horry ...... 130 Darlington ...... 135 Horry ...... 185 Marion ...... 131 Dillon ...... 136 Marion ...... 227 Williamsburg ...... 132 Florence ...... 138 Marlboro ...... 228 Horry ...... 143 Marion ...... 149 I Marlboro ...... 150 G Infectious Disease Williamsburg ...... 151 Gastroenterology Florence ...... 54 Florence ...... 50 Horry ...... 94 Durable Medical Equipment Horry ...... 185 Chesterfield ...... 134 Williamsburg ...... 124 Infusion Therapy Darlington ...... 135 Florence ...... 139 Dillon ...... 136 General Practice Horry ...... 146 Florence ...... 139 Darlington ...... 3 Internal Medicine Horry ...... 181 Florence ...... 10 Chesterfield ...... 1 Marion ...... 149 Horry ...... 185 Darlington ...... 32 Marlboro ...... 150 General Surgery Dillon ...... 6 Williamsburg ...... 151 Chesterfield ...... 27 Florence ...... 56 Darlington ...... 32 Horry ...... 186 E Dillon ...... 38 Marion ...... 122 Ear Nose & Throat Florence ...... 52 Marlboro ...... 123 Darlington ...... 30 Horry ...... 185 Williamsburg ...... 124 Florence ...... 47 Marion ...... 121 Horry ...... 181 Marlboro ...... 123 Interventional Cardiology Williamsburg ...... 124 Florence ...... 56 Endocrinology Diabetes Meta- Horry ...... 98 bolism H Dillon ...... 38 L Florence ...... 48 Hand Surgery Horry ...... 86 Darlington ...... 32 Laboratory Pathology Testing Florence ...... 52 All ...... 133 Florence ...... 140 F Horry ...... 92 Horry ...... 147 Family Practice Hematology & Oncology Marion ...... 149 Chesterfield ...... 152 Florence ...... 53 Williamsburg ...... 151 Darlington ...... 153 Horry ...... 93 Dillon ...... 38 Licensed Clinical Social Worker Florence ...... 162 Home Health Care Chesterfield ...... 152 Horry ...... 181 Florence ...... 139 Darlington ...... 153 Marion ...... 121 Dillon ...... 158

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Specialty Providers At-A-Glance L - cont. Horry ...... 98 Dillon ...... 159 Florence ...... 171 Florence ...... 163 Horry ...... 206 Horry ...... 189 N Marion ...... 227 Marlboro ...... 228 Neonatal Perinatal Medicine Marlboro ...... 229 Williamsburg ...... 231 Florence ...... 57 Williamsburg ...... 231 Licensed Independent Social Nephrology Nurse Practitioner Gerentology Worker Darlington ...... 32 Chesterfield ...... 152 Darlington ...... 154 Florence ...... 58 Florence ...... 172 Dillon ...... 158 Horry ...... 98 Williamsburg ...... 124 Florence ...... 163 Nurse Practitioner Pediatric Horry ...... 189 Neuro Psychiatrist Md Darlington ...... 156 Horry ...... 206 Licensed Marriage And Family Chesterfield ...... 27 Williamsburg ...... 231 Therapist Florence ...... 58 Horry ...... 190 Nurse Practitioner Psychiatric Marlboro ...... 228 Neurology Chesterfield ...... 28 Mental Health Darlington ...... 156 Licensed Master Social Worker Dillon ...... 42 Horry ...... 206 Horry ...... 190 Florence ...... 62 Horry ...... 196 Nurse Practitioner Womens Licensed Mental Health Coun- Health selor Neuropsychology Florence ...... 172 Florence ...... 163 Darlington ...... 32 Florence ...... 62 Horry ...... 206 Licensed Professional Counselor Nurse Practitioner Chesterfield ...... 152 Neuroradiology Darlington ...... 155 Darlington ...... 155 Darlington ...... 32 Dillon ...... 158 Dillon ...... 158 Florence ...... 62 Florence ...... 169 Florence ...... 167 Horry ...... 200 Horry ...... 195 Neurosurgery Marion ...... 227 Marion ...... 227 Florence ...... 63 Marlboro ...... 229 Marlboro ...... 229 Horry ...... 196 Williamsburg ...... 231 Williamsburg ...... 231 Nurse Practitioner Acute Care Nutrition Licensed Social Worker Florence ...... 169 Florence ...... 172 Florence ...... 167 Horry ...... 200 Horry ...... 206 Horry ...... 196 Nurse Practitioner Adult Health Marion ...... 227 Chesterfield ...... 152 O Horry ...... 200 M Obstetrics/Gynecology Marlboro ...... 229 Chesterfield ...... 28 Maternal Fetal Medicine Darlington ...... 156 Florence ...... 57 Nurse Practitioner Family Dillon ...... 43 Medicine Florence ...... 65 Medical Oncology Chesterfield ...... 152 Horry ...... 206 Florence ...... 57 Darlington ...... 156

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Specialty Providers At-A-Glance O - cont. Florence ...... 140 Physician Assistant Horry ...... 147 Darlington ...... 157 Marion ...... 122 Florence ...... 176 Marlboro ...... 123 Horry ...... 219 Williamsburg ...... 124 P Pain Management Marion ...... 227 Occupational Therapy Florence ...... 71 Plastic & Reconstructive Surgery Darlington ...... 156 Horry ...... 110 Florence ...... 72 Florence ...... 173 Horry ...... 111 Horry ...... 208 Pediatric Cardiology Florence ...... 72 Podiatry Ophthalmology Florence ...... 73 Chesterfield ...... 28 Pediatric Endocrinology Horry ...... 219 Darlington ...... 33 Florence ...... 72 Williamsburg ...... 125 Dillon ...... 44 Florence ...... 67 Pediatric Surgery Horry ...... 110 Preventive Medicine Horry ...... 104 Florence ...... 73 Pediatrics Optician Professional Counselor Darlington ...... 34 Chesterfield ...... 152 Darlington ...... 156 Chesterfield ...... 152 Florence ...... 67 Florence ...... 177 Horry ...... 105 Dillon ...... 6 Florence ...... 72 Horry ...... 220 Marion ...... 227 Optometry Horry ...... 209 Marlboro ...... 230 Chesterfield ...... 29 Marlboro ...... 229 Darlington ...... 35 Psychiatry Dillon ...... 44 Physical Medicine & Rehabilita- tion Chesterfield ...... 29 Florence ...... 69 Florence ...... 72 Darlington ...... 157 Horry ...... 108 Horry ...... 111 Florence ...... 74 Marion ...... 122 Horry ...... 112 Marlboro ...... 123 Physical Therapy Williamsburg ...... 124 Darlington ...... 156 Psychology Dillon ...... 159 Dillon ...... 44 Oral & Maxillofacial Surgery Florence ...... 174 Florence ...... 75 Florence ...... 69 Horry ...... 216 Horry ...... 112 Williamsburg ...... 125 Orthopaedic Surgery Marion ...... 227 Marlboro ...... 229 Darlington ...... 36 Pulmonary Disease Dillon ...... 44 Physician Assistant Family Darlington ...... 36 Florence ...... 173 Medicine Florence ...... 76 Horry ...... 110 Florence ...... 176 Horry ...... 113 Marion ...... 122 Horry ...... 219 Marlboro ...... 123 R Williamsburg ...... 125 Physician Assistant Orthopedics Radiation Oncology Horry ...... 219 Orthotics & Prosthetics Florence ...... 76 Darlington ...... 135 Horry ...... 114

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Specialty Providers At-A-Glance R - cont. Florence ...... 77 Rehabilitation Facility Substance Abuse Florence ...... 140 Florence ...... 178 Retail Chesterfield ...... 232 T Darlington ...... 233 Thoracic & Cardiovascular Dillon ...... 234 Surgery Florence ...... 236 Florence ...... 78 Horry ...... 240 Horry ...... 225 Marion ...... 241 Thoracic Surgery Marlboro ...... 242 Florence ...... 178 Williamsburg ...... 243 Horry ...... 115 Rheumatology Williamsburg ...... 125 Florence ...... 76 Horry ...... 114 U Urology Rural Health Center Darlington ...... 37 Marion ...... 24 Dillon ...... 44 Florence ...... 79 S Horry ...... 226 Skilled Nursing Facility Marion ...... 122 Horry ...... 147 Williamsburg ...... 125 Marion ...... 149 Marlboro ...... 150 V Vascular Surgery Sleep Diagnostic Studies Chesterfield ...... 29 Dillon ...... 136 Florence ...... 178 Florence ...... 140 Horry ...... 120 Horry ...... 148

Speech & Language Pathology Darlington ...... 157 Florence ...... 177 Horry ...... 222 Marion ...... 227

Speech Therapy Florence ...... 178 Horry ...... 225 Marion ...... 227 Williamsburg ...... 231

Sports Medicine Darlington ...... 37

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Extended Hours Index You can find a provider who has longer office hours in this index. First look for the provider’s name. Then check the county and page number. You can go to that page to get the provider’s office hours. Indice de horarios extendidos: En este índice, usted puede encontrar un proveedor con horario más prolongado de atención en el consultorio. Primero busque el nombre del proveedor, y luego verifique el condado y el número de página. Consulte esa página para obtener el horario de atención del proveedor.

Chesterfield Mohr, Richard MD ...... 31 Optometry Padgett, Edwin MD ...... 31 Covington, Al OD ...... 28 Dialysis Pageland Dialysis ...... 134 General Surgery Professional Counselor Bannister, Carroll MD ...... 31 Ellison, Beatrice LPC ...... 152 Durable Medical Equipment Bridges And Jamesinc Hospital Wannamaker Drug ...... 134 Retail Carolina Pines Regional Medical CVS Pharmacy ...... 232 Center ...... 127 Chesterfield Drug Company ...232 Hospital Mcleod Medica Center Csc Community Pharmacy ...... 232 Mcleod Health Cheraw ...... 126 Darlington ...... 127 Harseys Pharmacy ...... 232 P & H Pharmacy ...... 232 Internal Medicine Pageland Family Pharmacy ...... 232 Licensed Professional Counselor Edosomwan, Emmanuel MD ...... 1 Sandhills Medical Pharmacy ....232 Pressley, Veronica LPC ...... 154 Walmart Pharmacy ...... 232 Serafin, Jeremy LPC ...... 154 Licensed Professional Counselor Wannamaker Drug ...... 232 Etheridge, Martin LPC ...... 152 Wannamakers Drug Store ...... 232 Neuropsychology Evans, Patricia LPC ...... 152 West, Jesse PHD ...... 32 Wallace, Panora LPC ...... 152 Darlington Nurse Practitioner Family Community Mental Health Medicine Neurology Center Tedder, Tona APRN ...... 155 Almidani, Mazen MD ...... 27 Pee Dee Mental Health Center 135 Corti, Sandro MD ...... 27 Woodward, Tracie APRN ...... 156 Khishchenko, Natan MD ...... 27 Ear Nose & Throat Li, Sui MD ...... 27 Nurse Practitioner Pediatric Dyce, Orville MD ...... 30 Mehari, Tigist MD ...... 28 Jackson, Haley APRN ...... 156 Mendelson, Joshua MD ...... 28 Mcleod, Casey APRN ...... 156 Murtaza, Amir MD ...... 28 Family Practice Moore, Casey APRN ...... 156 Newman, Richard MD ...... 28 Brewton, Mary DO ...... 31 Null, Elizabeth MD ...... 28 Dickinson, Elizabeth MD ...... 31 Nurse Practitioner Patel, Neil MD ...... 28 Dickinson, Thomas MD ...... 2 Wicker, Maryum APRN ...... 155 Howington, Bryan MD ...... 31 Lanning Lowther, Lisa DO ...... 31

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Extended Hours Index Darlington - cont. Gupta, Raina MD ...... 40 Speech & Language Pathology Heller, Adam MD ...... 40 Quinn, Elizabeth SLP ...... 157 Occupational Therapy Jimenez-Sanders, Rebecca MD 40 Reames, Danielle SLP ...... 157 Ingram, Irene OT ...... 156 Khishchenko, Natan MD ...... 40 Lamar, Cory MD ...... 40 Dillon Li, Sui MD ...... 40 Optician Lue, Stanley MD ...... 40 Eyes Over Carolina PC ...... 34 Certified Nurse Anesthetist Masud, Muhammad MD ...... 40 Walmart Vision Center ...... 34 Torgersen, Keith CRNA ...... 158 Mcdonald, Mark MD ...... 40 Mednick, Adam MD ...... 40 Optometry Chiropractic Mendelson, Joshua MD ...... 41 Brinton, Evan OD ...... 34 Cline, Matthew DC ...... 38 Meyers, Clifford MD ...... 41 Mitchell, Edwin OD ...... 34 Nodrick, Deborah MD ...... 38 Mojumder, Deb MD ...... 41 Panicker, Jaison OD ...... 35 Mowzoon, Mina MD ...... 41 Scruggs, Miles OD ...... 35 Family Practice Murtaza, Amir MD ...... 41 Zeplin, Vincent OD ...... 35 Fitzgibbon, Timothy MD ...... 6 Nagaraja, Harsha MD ...... 41 Freel, Paul MD ...... 6 Newman, Richard MD ...... 41 Pediatrics Shealy, Robin MD ...... 6 Null, Elizabeth MD ...... 41 Budhram, Solomon MD ...... 4 Vance, Stephen MD ...... 6 Patel, Neil MD ...... 41 Japitana, Marian MD ...... 4 Plancher, Joao Mc-Oneil MD ..... 41 Riordan, Katherine MD ...... 41 Morphis, James MD ...... 4 Hospital Ovanna Budhram, Joni MD ...... 5 Saha, Sam MD ...... 41 Mcleod Medical Center Dillon 128 Sebesto, Jason DO ...... 41 Sevilis, Theresa DO ...... 42 Psychiatry Neurology Snyder, Michael MD ...... 42 Tohid, Usman PA ...... 157 Abalsom, Nicholas MD ...... 38 Sombutmai, Chut DO ...... 42 Aguilar, Maria MD ...... 38 Tigist, Mehari MD ...... 42 Pulmonary Disease Almidani, Mazen MD ...... 38 Vajapey, Geetanjali MD ...... 42 Barnard, Mark MD ...... 36 Amir, Murtaza MD ...... 38 Valanta, Douglas MD ...... 42 Avila, Amanda MD ...... 39 Vega, Jose MD ...... 42 Vidgop, Yelana MD ...... 42 Retail Baluja, Vivek MD ...... 39 Won, Mai MD ...... 42 CVS Pharmacy ...... 233 Behravan, Vahid MD ...... 39 Zaman, Mohammed DO ...... 42 Carolina Drug Store Inc ...... 233 Bixler, Christopher MD ...... 39 Csc Community Pharmacy ...... 233 Borte, Bernadette MD ...... 39 Csc Community Boudreau, Michelle DO ...... 39 Obstetrics/Gynecology Pharmacy-Society Hill ...... 233 Bradley, Nina DO ...... 39 Climer, Clyde MD ...... 42 Darlington Family Pharmacy .... 233 Cheshire, Amanda MD ...... 39 Hartsville Drug Company Inc .. 233 Chumble, Shubhangi MD ...... 39 Colongarcia, Patricia MD ...... 39 Pediatrics Lamar Family Pharmacy ...... 233 Ramirez, Yvonne MD ...... 6 Nursing Home Dispensary ...... 233 Corti, Sandro MD ...... 39 Professional Pharmacy ...... 233 Dhadwal, Neetu MD ...... 39 Walmart Pharmacy ...... 233 Feliciano, Carlos MD ...... 39 Retail Figueroa Garcia, Alberto MD ....40 CVS Pharmacy ...... 234 Floyd, Jessica MD ...... 40 Csc Community Pharmacy-Latta Friedman, Mark DO ...... 40 ...... 234

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Extended Hours Index

Dillon - cont. Dialysis Infectious Disease Dillon Community Pharmacy ..234 Fresenius Kidney Care Florence Olatosi, Akinwale MD ...... 54 Latta Drug Co Inc ...... 234 Home ...... 138 Walmart Pharmacy ...... 234 Fresenius Kidney Care Florence Internal Medicine Medical M ...... 138 Adabala, Nivedita MD ...... 10 Florence Charyalu, Maddalithirumala MD Durable Medical Equipment ...... 54 Behavioral Health Counseling K J Pharmacy 129 ...... 138 Singh, Harmohan MD ...... 55 Williamson, Heather LCSW ...... 160

Endocrinology Diabetes Meta- Licensed Clinical Social Worker Certified Nurse Anesthetist bolism Black, Sharon CSW ...... 162 Bird, Bryan CRNA ...... 160 Culleton, John MD ...... 48 Blackmon, Tomekia LCSW ...... 162 Eastep, Alyson CRNA ...... 160 Brady, Melissa CSW ...... 162 Jones, Karen CRNA ...... 160 Oeffinger, Rebecca CSW ...... 162 Jones, Trisha CRNA ...... 160 Family Practice Sanders, Lecole LCSW ...... 162 Smith, Allan CRNA ...... 161 Artis Bacote, Karen NP ...... 7 Wilson, Toni Marie CSW ...... 163 Thomas, Brady CRNA ...... 161 Brewton, Mary DO ...... 48 Tyner, Christopher CRNA ...... 161 Bruce, Valarian MD ...... 48 Dickinson, Elizabeth MD ...... 48 Licensed Mental Health Coun- Dickinson, Thomas MD ...... 7 selor Chiropractic Howington, Bryan MD ...... 48 Malvarosa, Paul LPC ...... 163 Bergrin, Jon DC ...... 46 Lanning Lowther, Lisa DO ...... 48 Ferrigno, Michael DC ...... 46 Mohr, Richard MD ...... 49 Gittens, David DC ...... 47 Licensed Professional Counselor Morgan, Patrick MD ...... 49 Hutcheson, Brian DC ...... 47 Bakas, Efstasia LPC ...... 163 Morris, Judy NP ...... 9 Jordan, Chucky DC ...... 47 Daniels, Prezillic LPC ...... 163 Moskos, Frank MD ...... 49 Patel, Kunal DC ...... 47 Dennis, Brandi LPC ...... 163 Padgett, Edwin MD ...... 49 Stone, Amanda DC ...... 47 Durant, Kelvin LPC ...... 163 Strauss, Louis MD ...... 49 Wenner, Bryan DC ...... 47 Elkins, Jennifer LPC ...... 163 Zeleke, Akal MD ...... 49 Fulcher, Rosanne LPC ...... 164 Fuller, Clara LPC ...... 164 Clinical Social Work Home Health Care Gonzales Acevado, Camille LPC Carter, Kaycee CSW ...... 162 Loving Arms Home Care LLC ..139 ...... 164 Graham, Carrie LPC ...... 164 Community Mental Health Hospital Graham, Elizabeth LPC ...... 164 Center Lake City Community Hospital Jefferson, Samantha LPC ...... 164 Pee Dee Mental Health Center 137 ...... 129 Kahn, David LCSW ...... 164 Mcleod Regional Medical Center Knight, Aimee LPC ...... 164 Diagnostic Imaging ...... 129 Langley, Laura LPC ...... 164 Palmetto Imaging Inc DBA Musc Health Florence Medical Lobo, Vanessa LPC ...... 165 Florence MRI ...... 138 Center ...... 129 Lownsberry, Erick LPC ...... 165 Macaluso, Sherry LPC ...... 165 Martin, John LPC ...... 165 Mazgaj, Jamie LPC ...... 165 Mcclam, Andrea LPC ...... 165

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Extended Hours Index Florence - cont. Colon-Garcia, Patricia MD ...... 59 Fulwood, Karen APRN ...... 169 Corti, Sandro MD ...... 59 Gainey, Cynthia APRN ...... 169 Mcdaniel, Anita LPC ...... 165 Dhadwal, Neetu MD ...... 59 Lawrimore, Cynthia APRN ...... 170 Muldrow, Javonnia LPC ...... 165 Feliciano, Carlos MD ...... 59 Peters, Jon APRN ...... 170 Nance, Clyde LPC ...... 165 Figueroa Garcia, Alberto MD .... 59 Smith, Morgan APRN ...... 171 Rintelman, Michael LPC ...... 166 Floyd, Jessica MD ...... 59 Weaver, Timothy APRN ...... 171 Rogers, Mary LPC ...... 166 Friedman, Mark DO ...... 60 Rush, Amy LPC ...... 166 Gupta, Raina MD ...... 60 Simon-Mcqueen, Ryedenna Nurse Practitioner Gerentology Heller, Adam MD ...... 60 LMHC ...... 166 Kight, Paige APRN ...... 172 Jimenez-Sanders, Rebecca MD 60 Stewart, Martha LPC ...... 166 Kass, Robin MD ...... 60 Townsend, Anna LPC ...... 166 Lamar, Cory MD ...... 60 Nurse Practitioner Tyner, Faith LPC ...... 167 Li, Mian MD ...... 60 Chinich, Caren CNP ...... 168 Wallace, Donya LPC ...... 167 Li, Sui MD ...... 60 Gude, Adam CNP ...... 168 Whitman, Gretchen LPC ...... 167 Lue, Stanley MD ...... 60 Hamer, Melissa APRN ...... 168 Williams, Misty LPC ...... 167 Masud, Muhammad MD ...... 60 Pritchard, Pamela APRN ...... 169 Mcdonald, Mark MD ...... 61 Rogers, Katelyn APRN ...... 169 Licensed Social Worker Mednick, Adam MD ...... 61 Stephen, Natasha CNP ...... 169 Wright, Carol LSW ...... 167 Mehari, Tigist MD ...... 61 Wicker, Maryum APRN ...... 169 Meyers, Clifford MD ...... 61 Neonatal Perinatal Medicine Mojumder, Deb MD ...... 61 Nutrition Moeckel, Douglas MD ...... 57 Mowzoon, Nima MD ...... 61 Finklea, Kitty RD ...... 172 Nagaraja, Harsha MD ...... 61 Patel, Neil MD ...... 61 Obstetrics/Gynecology Nephrology Plancher, Joao Mc-Oneil MD ..... 61 Tollison, Steven MD ...... 65 Alsaka, Mhd MD ...... 57 Riordan, Katherine MD ...... 61 Regmi, Subash MD ...... 58 Saha, Sam MD ...... 61 Sebesto, Jason DO ...... 62 Optician Neuro Psychiatrist Md Sevilis, Theresa DO ...... 62 Eyemart Express LLC ...... 67 Smock, Alison MD ...... 58 Shissias, Charles MD ...... 62 Walmart Vision Center ...... 67 Snyder, Michael MD ...... 62 Neurology Sombutmai, Chut DO ...... 62 Optometry Abalsom, Nicholas MD ...... 58 Vajapey, Geetanjali MD ...... 62 Bergelt, Solita OD ...... 68 Aguilar, Maria MD ...... 58 Valanta, Douglas MD ...... 62 Brooks, Michelle OD ...... 68 Amir, Murtaza MD ...... 58 Vidgop, Yelana MD ...... 62 Hobbs, Steven OD ...... 68 Avila, Amanda MD ...... 58 Won, Mai MD ...... 62 Zeplin, Vincent OD ...... 69 Baluja, Vivek MD ...... 58 Zaman, Mohammed DO ...... 62 Behravan, Vahid MD ...... 58 Pediatrics Bixler, Christopher MD ...... 59 Neuropsychology Collins, Charles MD ...... 11 Borte, Bernadette MD ...... 59 Hagan, Timothy MD ...... 62 Elder, Benjamin MD ...... 11 Boudreau, Michelle DO ...... 59 Graham, Toney MD ...... 11 Bradley, Nina DO ...... 59 Nurse Practitioner Family Hartzog, Timothy MD ...... 72 Cheshire, Amanda MD ...... 59 Medicine Minter, Ellen Patrice MD ...... 12 Chumble, Shubhangi MD ...... 59 Brown, Angel APRN ...... 169

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Extended Hours Index Florence - cont. Sanders, Alexis PHD ...... 74 Horry Scearce, Edward PSYD ...... 75 Naylor, Brian MD ...... 12 Steele, Patrick CP ...... 75 Behavioral Health Facility Horry County Commission On Physical Therapy Rehabilitation Facility Alcohol Drug ...... 141 Belser Jr, Roy PT ...... 173 Healthsouth Rehabilitation Bushman, Michael PT ...... 173 Hospital Of F ...... 140 Certified Nurse Anesthetist Floyd, Whitney PT ...... 173 Post, Moira CRNA ...... 180 Mcabee, Andrew PT ...... 174 Retail Advantage Pharmacy And Certified Nurse Midwife Physician Assistant Wellness ...... 235 Andrada, Marta CNM ...... 180 Black, Neicole PA ...... 174 CVS Pharmacy ...... 235 Knippen, Elizabeth PA ...... 175 Careplusrx Pharmacy ...... 235 Chiropractic Pittard, Michelle PA ...... 175 F & L Drug Store ...... 235 Cline, Matthew DC ...... 83 Thomas, Julie PA ...... 176 Kjs Pharmacy 129 ...... 235 Hemingway, Jenica DC ...... 84 Longs Drug ...... 235 Podiatry M & D Drug Company ...... 235 Baker, Jordanna DPM ...... 72 Mcleod Outpatient Pharmacy 235 Clinical Social Work Medicine Mart ...... 235 Beck, Marcia CSW ...... 180 Davis, Rochelle LCSW ...... 181 Preventive Medicine Omnicare Of Florence ...... 235 Leisy, Heather MD ...... 73 Palmetto Prescription Center 235 Pamplico Pharmacy ...... 235 Convenient Care Clinic Piggly Wiggly Pharmacy ...... 236 Minuteclinic Diagnostic South Professional Counselor Professional Pharmacy Of Olanta Carolina ...... 142 Bendle, Lakyn LPC ...... 176 ...... 236 Minuteclinic LLC ...... 142 Daniels, Prezillic LPC ...... 176 Sams Club Pharmacy ...... 236 Durant, Kelvin LPC ...... 176 The Medicine Cabinet ...... 236 Fuller, Clara LPC ...... 177 The Pharmacy ...... 236 Dialysis Moore, Christopher LPC ...... 177 Timmonsville Pharmacy ...... 236 Myrtle Beach Dialysis ...... 143 Roberts, Kimberly LPC ...... 177 Vistara Pharmacy ...... 236 Simon Mcqueen, Ryedenna LPC Wall Drugs Of Johnsonville Inc Durable Medical Equipment ...... 177 ...... 236 Apria Healthcare LLC ...... 143 Wall Drugs Of Pamplico Inc ....236 Wright, Lisa MD ...... 145 Psychiatry Walmart Pharmacy ...... 236 Well Center Pharmacy ...... 236 Reusche, Christian MD ...... 73 Family Practice Shissias, Charles MD ...... 74 Borst, Christopher MD ...... 13 Rheumatology Brown, Alexis MD ...... 13 Psychology Turner III, Robert MD ...... 76 Cress, Lyndsi DO ...... 13 Adams, Carol CP ...... 74 Eaton, Richard MD ...... 13 Adams, Leah PSYD ...... 74 Joslin, Richard MD ...... 15 Anderson, Jason PSYD ...... 74 Meixel, Steven MD ...... 15 Hunter, William PSYD ...... 74 Muntean, Dan MD ...... 16 Jackel, Lisa PHD ...... 74 Nirenstein, Michael MD ...... 16 Pritchard-Boone, Andrea PHD . 74 Ross, Scott MD ...... 16

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Extended Hours Index Horry - cont. Lookadoo, Brian LPC ...... 193 Licensed Clinical Social Worker Lynch, Bruce LPC ...... 193 Stone, Kaitlin APRN ...... 181 Bovey, Diantha LSW ...... 186 Malkasian, Loren LPC ...... 193 Surratt, Susan ARNP ...... 181 Bush, Crystal CSW ...... 186 Malkasian, Paul LPC ...... 193 Vandergriff, Joseph MD ...... 17 Jackson, Debbie CSW ...... 187 Martin, Laura LPC ...... 193 Vest, James MD ...... 18 Lewis, Kellie CSW ...... 187 Mccarthy, Robert LPC ...... 193 Vinson, Tiffany MD ...... 18 Lyons, Ruth LCSW ...... 187 Mcgonigal, Jennifer LPC ...... 194 Wilkoszewski, Artur MD ...... 18 Mcfarland, Lindsey CSW ...... 187 Mercer, Amanda LPC ...... 194 Nelsen, Cara LCSW ...... 187 Onley Livingston, Angel LPC ....194 Federally Qualified Health Nixon, Bevin CSW ...... 187 Pickett, Michael LPC ...... 194 Center Norman, Mary CSW ...... 187 Stewart, Caren LPC ...... 194 Andrada, Marta CNM ...... 182 Robinette, Lester CSW ...... 188 Stutler, Tammy LPC ...... 194 Bush, Crystal CSW ...... 182 Roman, John LCSW ...... 189 Unger, Patricia LPC ...... 194 Davis, Rochelle LCSW ...... 182 Seitzinger, Veronica CSW ...... 189 Whitman, Gretchen LPC ...... 195 Elliott, Alexis LSW ...... 182 Freeman, Katherine APRN ...... 182 Licensed Independent Social Medical Oncology Grady, Cynthia MD ...... 145 Worker Paudel, Vijay MD ...... 98 Little River Medical Center ...... 18 Elliott, Alexis LSW ...... 189 Painter, Autumn APRN ...... 183 Taylor, Laura MD ...... 146 Neurology Licensed Marriage And Family Almidani, Mazen MD ...... 98 Therapist Colongarcia, Patricia MD ...... 99 General Practice Beres, Danielle LMFT ...... 189 Figueroa Garcia, Alberto MD ....99 Turek, James MD ...... 19 Carter, Robert LMFT ...... 190 Khishchenko, Natan MD ...... 99 Mcdonald, Mark MD ...... 99 Hematology & Oncology Licensed Master Social Worker Mendelson, Joshua MD ...... 99 Brown, Dejuania DO ...... 93 Mottey, Kristen CSW ...... 190 Newman, Richard MD ...... 99 Goldberg, Renwick MD ...... 93 Null, Elizabeth MD ...... 99 Henderson, Jordan DO ...... 93 Licensed Professional Counselor Vega, Jose MD ...... 100 Touloukian, Emily DO ...... 93 Anderson, Jill LPC ...... 190 Vidgop, Yelana MD ...... 100 Bogle, Roberta LPC ...... 190 Hospital Bulsza, Susan LPC ...... 190 Nurse Practitioner Family Grand Strand Regional Medical Campbell, Thomas LPC ...... 191 Medicine Center ...... 130 Cantley, Amy LMHC ...... 191 Anderson, Alicia APRN ...... 201 Mcleod Loris Seacoast Ho ...... 130 Davis, Nancy LPC ...... 191 Belschner, Rebecca APRN ...... 201 Dennis, Brandi LPC ...... 191 Brown, Tisha APRN ...... 201 Internal Medicine Everhart Lachnicht, Ashley LPC 191 Butbul Benezra, Vered APRN ..202 Allen, Sarah MD ...... 19 Fortune, Jane LPC ...... 192 Byrd, Mary APRN ...... 202 Brazee, Jacob DO ...... 19 Frasier, Colisha LPC ...... 192 Campbell, Heather APRN ...... 202 Hassan, Alkhatib MD ...... 95 Goodall, Kristina LPC ...... 192 Crawford, Stephanie APRN .....202 Mclaughlin, Matthew DO ...... 96 Goyeneche, Paola LPC ...... 192 Crum, Christopher APRN ...... 202 Remines, Michael DO ...... 20 Harper, Phillip LPC ...... 192 Farley, Colleen APRN ...... 203 Swift, Catherine MD ...... 97 Harrington, Teressa LPC ...... 192 Freeman, Katherine APRN ...... 203 Varney, Michael MD ...... 21 John Deloaceh ...... 192 Gibbs, Ashley APRN ...... 204 King, Ellen LPC ...... 192 Hewitt, Brenda APRN ...... 204

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Extended Hours Index Horry - cont. Torosian, Valeriya OT ...... 208 Singh, Githa PT ...... 215 Vermillion, Krystal OT ...... 208 Hightower, Stephanie APRN ...204 Williams, Taylor OT ...... 208 Lee, Jennifer APRN ...... 205 Physician Assistant Menser, Cheryl APRN ...... 205 Deshon, Laurie PA ...... 217 Painter, Autumn APRN ...... 205 Optician Frye, Fritz PA ...... 217 Plowman, Lesley APRN ...... 205 Eyemart Express LLC ...... 104 Loomis, Alexandra PA ...... 218 Schultz-Peters, Sandra APRN ..205 Mgb Eyes Inc ...... 104 Melgar, Tammy PA ...... 218 Smith, Justin CNP ...... 206 Walmart Vision Center ...... 105 Offenback, Richard PA ...... 218 Smith, Tara APRN ...... 205 Roode, Richard PA ...... 218 Stanley, Regina APRN ...... 206 Optometry Shaver, Robin PA ...... 218 States, Lindsey APRN ...... 206 Allouch, Fouad OD ...... 105 Troutman, Ina PA ...... 219 Caugh, Kurtis OD ...... 106 Tumbleson, Catherine PA ...... 219 Nurse Practitioner Pediatric Creson, Stuart OD ...... 106 Bruce, Amanda APRN ...... 206 Graham, Lauri OD ...... 106 Plastic & Reconstructive Surgery Lee, Amanda OD ...... 106 White, Steven MD ...... 111 Merhi, Eva OD ...... 106 Nurse Practitioner Poole, R Gary OD ...... 107 Anderson, Alicia NP ...... 21 Professional Counselor Vaught, Heather OD ...... 108 Batten, Ashley APRN ...... 196 Murray, David LPC ...... 219 Vaught, James Dylan OD ...... 107 Brinegar, Angela APRN ...... 196 Seitzinger, Veronica CSW ...... 219 Vaught, James OD ...... 107 Dorr, Rachel APRN ...... 198 Talbert, Wendy LPC ...... 220 Weiner, Edward OD ...... 108 Dorr, Rachel NP ...... 21 Vanhoogen, Ut Uyen LPC ...... 220 Wise, Garett OD ...... 108 Lang, Yolanda APRN ...... 199 Zeplin, Vincent OD ...... 108 Lindsay, Christine APRN ...... 199 Psychiatry Moleins, Dawn APRN ...... 199 Oduwole, Adedapo MD ...... 112 Wilson, Ryan APRN ...... 200 Pediatrics Corontzes, Stephen MD ...... 22 Eglen, Rebecca MD ...... 22 Retail Obstetrics/Gynecology Hall, Megan DO ...... 111 Atlantic Apothecary ...... 237 Grady, Cynthia MD ...... 102 Pelinka, Sarah APRN ...... 209 Aynor Family Pharmacy ...... 237 Wakefield, Hannah MD ...... 111 CVS Pharmacy ...... 238 Occupational Therapy Carolina Forest Pharmacy ...... 238 Arthur, Rachel OT ...... 207 Carolina Health Pharmacy ...... 238 Physical Therapy Brunson, Monica OT ...... 207 Cherry Grove Drug ...... 238 Congdon, Karyn PT ...... 210 Dixon, Heather OT ...... 207 Conway Pharmacy ...... 238 Demarco, Donna PT ...... 210 Egan, Brad OT ...... 207 Costco Pharmacies ...... 238 Fitzgerald, John PT ...... 211 Farnill, Leslie OT ...... 207 Golden Town Pharmacy ...... 238 Foster, Karen PT ...... 211 Hafenbreidel, Jill OT ...... 207 Kroger Drugstore ...... 238 Gibson, Elizabeth PT ...... 211 Hardee, Katherine OT ...... 207 Kroger Pharmacy ...... 238 Kunz, Rachel PT ...... 213 Lewis, Katie OT ...... 208 Kroger Sav-On ...... 238 Laspada, Raymond PT ...... 213 Mims, Teresa OT ...... 208 Loris Drug Store ...... 238 Lynch, Nancy PT ...... 214 Prock, Kelly OT ...... 208 Medicine Mart ...... 239 Montenery, Jason PT ...... 214 Roberts, Juliet OT ...... 208 Nyes Pharmacy ...... 239 Patton, Melissa PT ...... 214 Stull, Ashley OT ...... 208 Ocean Lakes Pharmacy ...... 239 Pecylak, Colleen PT ...... 214 Tardy, Paul OT ...... 208 Publix Super Markets ...... 239

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Extended Hours Index Horry - cont. Palmer, Susan SLP ...... 221 Price, Stacie SLP ...... 221 Hospital Rivertown Pharmacy Inc ...... 239 Rogers, Cheryl SLP ...... 221 Musc Health Marion Medical Sams Club Pharmacy ...... 239 Center ...... 131 Stewart, Danielle SLP ...... 222 Seashore Drugs ...... 239 Truesdale, Lakisha SLP ...... 222 Sherrys Meds And More Walker, James SLP ...... 222 Nurse Practitioner Family Pharmacy ...... 239 Warren, Michelle SLP ...... 222 Medicine The Medicine Shoppe ...... 239 Weingart, Kristin SLP ...... 222 Painter, Autumn APRN ...... 227 Walgreens Drug Store ...... 239 White, Cameron SLP ...... 222 Walmart Pharmacy ...... 240 Wilson, Tanya SLP ...... 222 Waterway Pharmacy ...... 240 Professional Counselor Brown, Anita LPC ...... 227 Speech Therapy Skilled Nursing Facility Berry, Jessica SLP ...... 222 Carolina Healthcare Inc DBA Retail Compass Post ...... 147 Brooks, Jennifer SLP ...... 222 Bridgers Drug Store ...... 241 Conway Manor ...... 147 Cotter, Priscilla SLP ...... 222 CVS Pharmacy ...... 241 Ferguson, Kimberly SLP ...... 223 Carolina Pharmacy ...... 241 Harmon, Tonya SLP ...... 223 Health Care Partners Phcy Marion Sleep Diagnostic Studies Ivy, Amy ...... 223 ...... 241 Coastal Sleep Lab Inc ...... 147 Lloyd, Quincey SLP ...... 223 Mullins Discount Drug ...... 241 Oliver, Elizabeth SLP ...... 224 Walmart Pharmacy ...... 241 Speech & Language Pathology Parent, Jennifer SLP ...... 224 Ard, Kimberly SLP ...... 220 Pendergrass, Kimberly SLP ...... 224 Skilled Nursing Facility Bellavia, Lisa SLP ...... 220 Peterson, Barbara SLP ...... 224 Musc Health Mullins Nursing Blakely Wheeler, Valerie SLP ...220 Rogers, Susan SLP ...... 224 Center ...... 149 Britt, Josie SLP ...... 220 Schank, Stephanie SLP ...... 224 Brown, Natalie SLP ...... 220 Soles, Margaret SLP ...... 224 Burch, Bridget SLP ...... 220 Walter, Lauren SLP ...... 224 Speech & Language Pathology Carey, Amanda SLP ...... 220 Young-Cline, Nicole SLP ...... 224 Mason, Rachel SLP ...... 227 Combs, Susan SLP ...... 220 Zito, Caroline SLP ...... 225 Crowninshield, Jessica SLP ...... 220 Marlboro Cusack, Shemeka SLP ...... 220 Marion Dinello, Kaylee SLP ...... 220 Dialysis Fitzpatrick, Christine SLP ...... 220 Chiropractic Mccoll Dialysis ...... 150 Frye, Amanda SLP ...... 221 Falk, Mitchell DC ...... 121 Gibbons, Laura SLP ...... 221 Durable Medical Equipment Glover, Farrah SLP ...... 221 Community Mental Health Fowler Pharmacy ...... 150 Goings, Charity SLP ...... 221 Center Johnson, Nia SLP ...... 221 Pee Dee Mental Health Center Licensed Clinical Social Worker Jones Brown, Jacqueline SLP ....221 ...... 149 Smith, Robert CSW ...... 228 Jones, Michelle SLP ...... 221 Kellahan, Meredith SLP ...... 221 Federally Qualified Health Licensed Marriage And Family Lawrence, Emily SLP ...... 221 Center Therapist Lehman, Annie SLP ...... 221 Painter, Autumn APRN ...... 227 Merriman, Lisa SLP ...... 221 Beres, Danielle LMFT ...... 228

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Extended Hours Index

Marlboro - cont. Hospital Williamsburg Regional Hospital Licensed Professional Counselor ...... 132 Patterson, Yolanda LPC ...... 229 Stuckey, Dominica LPC ...... 229 Internal Medicine Natarajan, Sundar MD ...... 124 Physical Therapy Smith, Sherry PT ...... 229 Licensed Professional Counselor Wallace, Donya LPC ...... 231 Professional Counselor Johnson, Damien LPC ...... 230 Retail Black River Pharmacy ...... 243 Retail CVS Pharmacy ...... 243 CVS Pharmacy ...... 242 Greeleyville Pharmacy ...... 243 Csc Community Pharmacy Mccoll Stuckey Pharmacy ...... 243 ...... 242 Williamsburg Pharmacy ...... 243 Csc Community Phcy Bennettsville ...... 242 Fowler Pharmacy ...... 242 Thoracic Surgery Marlboro Drug Company ...... 242 Smith III, Charlie MD ...... 125 Medcare Pharmacy ...... 242 Walmart Pharmacy ...... 242

Skilled Nursing Facility Dundee Manor ...... 150

Williamsburg

Behavioral Health Facility Williamsburg County Department On Alchol ...... 151

Durable Medical Equipment American Homepatient ...... 151 Lincare Inc ...... 151

Family Practice Allen, Raymond MD ...... 26 Crosby, Thomas MD ...... 26

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Provider Index

A American Homepatient ...... 143,151 Bakas, Efstasia LPC ...... 163 Amir, Murtaza MD ...... 38,58 Baker, Jordanna DPM ...... 72 A Perfect Fit ...... 147 Andersen, Jason MD ...... 108 Balachandra, Sivanthan MD ...... 98 A1 Medical ...... 138 Anderson, Alicia APRN ...... 201 Bali, Arvind MD ...... 30 Abadie, Sebastian MD ...... 87,94 Anderson, Alicia NP ...... 21 Baluja, Vivek MD ...... 39,58 Abalsom, Nicholas MD ...... 38,58 Anderson, Jason PSYD ...... 74 Banda, Darlinda LPC ...... 152,228 Abdallah, Hatem MD ...... 50 Anderson, Jill LPC ...... 190 Bangco, Mario MD ...... 98 Abinsay, Alvin MD ...... 121 Andrada, Marta CNM ...... 180,182 Banks, Jerry MD ...... 13 Abushakra, Kimberly SLP ...... 222 Andrews, David OD ...... 67 Banner, Meredith CNP ...... 167 Acaylar, Francis MD ...... 25 Andrews, Jeri APRN ...... 153 Bannister, Carroll MD ...... 31 Adabala, Nivedita MD ...... 10 Andrews, Stephen DO ...... 113 Bardi, Christopher MD ...... 4,11 Adams, Carol CP ...... 74 Anglen, Jeffrey MD ...... 69 Barnard, Mark MD ...... 36 Adams, Jessica DO ...... 38 Angus, Joslyn MD ...... 7 Barnett, Andrietta APRN Adams, Leah PSYD ...... 74 Ansari, Shoukath MD ...... 49 ...... 196,201,206 Adams, Sara MD ...... 92,93,94 Anyim, Alecia MD ...... 10 Baroody, Brent MD ...... 32,33,63 Adamson, James MD ...... 19 Apple, Claire OT ...... 207 Barrett, Gary MD ...... 19 Adkins, Henry MD ...... 26 Appleby, Douglas MD ...... 81,114 Barrett, Jennifer APRN ...... 201 Adler, Brian MD ...... 19 Apria Healthcare LLC ...... 143 Barrett, Michael MD ...... 2,7 Advantage Pharmacy And Ard, Kimberly SLP ...... 220 Barrett, Valorie APRN ...... 153 Wellness ...... 235 Ardaman, Miles MD ...... 36 Barton, Garrett MD ...... 1 Aerocare ...... 143 Areephanthu, Abraham MD ...... 30 Barton, Kinzie MD ...... 1 Aguilar, Maria MD ...... 38,58 Armstrong, Morgan PA ...... 174 Bashall, Anthony MD ...... 95 Aiken, Sheryl APRN ...... 196 Arnette, Caren APRN ...... 158 Bashour, Shadi DO ...... 54 Al Hourany, Ramzy MD ...... 75 Arroyo, Julio MD ...... 53 Baslot, Joel PT ...... 227 Alan, Rodney MD ...... 69 Arthur, Rachel OT ...... 207 Bass, Morgan APRN ...... 155,169 Albury, Vanessa APRN ...... 201 Artis Bacote, Karen NP ...... 7 Batten, Ashley APRN ...... 196 Alexander, Anthony MD ...... 72 Asaro, Joseph MD ...... 124 Bauer, Robert MD ...... 73 Alexander, Clarence MD ...... 7 Atienza, Jonessa Ann MD ...... 19 Beck, David MD ...... 108 Alexander, William OD ...... 34 Atkins III, John MD ...... 36 Beck, Marcia CSW ...... 180 Alford, Bryan PA ...... 173 Atkinson, Ernest MD ...... 26 Bednarski, Hania DO ...... 88 Ali, Hamed MD ...... 112 Atkinson, Meredith APRN .152,229 Beeraka, Prakash MD ...... 7,13 Alkis, Mallory MD ...... 56,63 Atlantic Apothecary ...... 237 Behling, Donald MD ...... 7 Allen, Dan PHD ...... 74 Avila, Amanda MD ...... 39,58 Behravan, Vahid MD ...... 39,58 Allen, Raymond MD ...... 26 Aynor Family Pharmacy ...... 237 Belk, Cindy OT ...... 172 Allen, Sarah MD ...... 19 Azizzadeh, Naceme DO ...... 7 Bell, Thomas MD ...... 2 Allen, Scott CRNA ...... 180 Bell, Virginia APRN ...... 196 Alley, Ashley APRN ...... 196 B Bellavia, Lisa SLP ...... 220 Allouch, Fouad OD ...... 105 Babb, Susan CRNA ...... 160 Belschner, Rebecca APRN ...... 201 Almeida, Nathan MD ...... 54,94 Babb, Yarrow PA ...... 178 Belser Jr, Roy PT ...... 173 Almidani, Mazen MD ...... 27,38,98 Bach, Christopher MD ...... 87,95 Benbow, Pamela AUD ...... 179 Alo, Olubunmi MD ...... 101 Badve, Siddharth MD ...... 35 Bendle, Lakyn LPC ...... 176 Alsaka, Mhd MD ...... 57 Bailey, Byron MD ...... 100,143 Bennett, Gregory DO ...... 81 Alsworth, Roberta PA ...... 216 Bailey, Lauren APRN ...... 229 Bennett, Meagan APRN ...... 152 Altena, Kristine PT ...... 209 Bajaj, Rajesh MD ...... 52,57 Bennett, Meagan ARNP ...... 162,167 Ambrose, Michael MD ...... 2

www.wellcare.com/South-Carolina | 261 38642781

Provider Index

B - cont. Bossinger, Steven MD ...... 78 Brown, Natalie SLP ...... 220 Bouchard, Kristen PT ...... 209 Brown, Regina OT ...... 207 Benson, Paul MD ...... 19,87 Boudreau, Michelle DO ...... 39,59 Brown, Rhonda APRN ...... 201 Beres, Danielle LMFT ...... 189,228 Boullion, Christopher DO ...... 108 Brown, Rhonda CNP ...... 197 Bergelt, Solita OD ...... 68 Bovey, Diantha LSW ...... 186 Brown, Tisha APRN ...... 201 Bergeron, Shawn LCSW ...... 186 Bowen, Cary PT ...... 209 Brown, Traesa MD ...... 7 Berglind, William MD ...... 38 Boyd, Louise MD ...... 63 Browning, John MD ...... 63 Bergrin, Jon DC ...... 46 Boyer, Jocelyn CSW ...... 153 Bruce, Amanda APRN ...... 206 Berry, Jessica SLP ...... 222 Brackett, Newton MD ...... 89 Bruce, Valarian MD ...... 48 Best, Darryl MD ...... 95 Bradley, Nina DO ...... 39,59 Bruno, Tara APRN ...... 197 Bethea, Lesa MD ...... 121 Brady, Melissa CSW ...... 162 Brunson, Monica OT ...... 207 Bethea, Orran APRN ...... 158 Brady, Stephen MD ...... 97 Brusyanina, Svetlana APRN ...... 197 Bethle, Joseph PA ...... 216 Bramblett, Melanie PA ...... 174 Bryan, John DC ...... 30 Bharadwaj, Ramesh MD ...... 53 Brangers, Jennifer PT ...... 209 Bryant, Stacie ARNP ...... 168 Bickerstaff, Charles MD ...... 124 Brazee, Jacob DO ...... 19 Buchanan, Blaine PA ...... 217 Bidell, Jill LPC ...... 190 Brazill, Brittany PT ...... 209 Budhram, Solomon MD ...... 4 Biester, Christina MD ...... 1,27,134 Breeden, Melissa PT ...... 209 Bullard, Robert MD ...... 121 Billue, David MD ...... 101 Brewton, Cary DO ...... 51 Bulsza, Susan LPC ...... 190 Bird, Bryan CRNA ...... 160 Brewton, Mary DO ...... 31,48 Bunten, Kimberly PT ...... 173 Bitar, Anas MD ...... 110 Bridgers Drug Store ...... 241 Burch, Bridget SLP ...... 220 Bittner, Benjamin OD ...... 105 Bridges And Jamesinc Burgess, Bradley LPC ...... 154 Bixler, Christopher MD ...... 39,59 Wannamaker Drug ...... 134 Burgess, Gloria LPC ...... 190 Bjerken, David MD ...... 88,89 Briggs, Jonathan ARNP ...... 201 Burgess, La'asha PA ...... 185 Black River Pharmacy ...... 243 Brinegar, Angela APRN ...... 196 Burke, Valerie MD ...... 122,149 Black, Neicole PA ...... 174 Brinton, Evan OD ...... 34 Burkert, Stephen PT ...... 210 Black, Sharon CSW ...... 162 Britt, Josie SLP ...... 220 Burrows, Dennis PHD ...... 137 Blackmon, Tomekia LCSW ...... 162 Britt, Loryn APRN ...... 158 Bush, Crystal CSW ...... 182,186 Blackwell, Joyce OT ...... 156,172 Britt, Mary APRN ...... 201 Bushman, Michael PT ...... 173 Blakely Wheeler, Valerie SLP ...220 Britton, Kallie PA ...... 217 Butbul Benezra, Vered APRN ..202 Blaker, Alan MD ...... 45 Brockman, Robert MD ...... 89 Butterworth, Michelle DPM 73,125 Blaker, Brian MD ...... 54,56 Brooks, Jennifer SLP ...... 222 Byrd, Mary APRN ...... 202 Blanton, Adam PA ...... 217 Brooks, Melissa MD ...... 6 Blasius, Melony MD ...... 172 C Brooks, Michelle OD ...... 68 Bledsoe, Keri OT ...... 156 CVS Pharmacy Brown, Alexis MD ...... 13 Bleyer, Peter MD ...... 86 ...... 232,233,234,235,237,238,241 Brown, Angel APRN ...... 169 Bodofsky, Gary OD ...... 105 Caldwell, Alice APRN ...... 153 Brown, Anita LPC ...... 227 Boggs, Chris MD ...... 13 Caldwell, Alice CNP ...... 155 Brown, Catherine LPC ...... 190 Bogle, Roberta LPC ...... 190 Calhoun, Amanda APRN ...... 202 Brown, Daniel PA ...... 185 Bolton, Paula PT ...... 209 Calhoun, Howard LPC ...... 191 Brown, Dejuania DO ...... 93 Bondi, Evelyn PT ...... 209 Camak, Kelsi LPC ...... 176 Brown, Elizabeth LCSW ...... 228 Bondy, Peter MD ...... 85 Campbell, Heather APRN ...... 202 Brown, Julia APRN ...... 197 Borden, Danika MD ...... 22 Campbell, Thomas LPC ...... 191 Brown, Kaitlyn PA ...... 197 Borst, Christopher MD ...... 13 Campbell, Treadwell MD ...... 24 Brown, Katherine OT ...... 207 Borte, Bernadette MD ...... 39,59 Campbell, William MD ...... 63 Brown, Morris MD ...... 7,26 Canaan, Yusef MD ...... 111

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Provider Index

C - cont. Charbel, Samer MD ...... 87 Coastal Carolina Otolaryngology Charles, Gabrielle PT ...... 210 ...... 85 Canipe, Karen APRN ...... 152 Charyalu, Maddalithirumala MD Coastal Sleep Lab Inc ...... 147 Cantley, Amy LMHC ...... 191 ...... 54 Coastal Vision Center Inc ...... 104 Cape Fear Orthotics & Prosthetics Chaubey, Vinod MD ...... 97 Coates Gal, Chrystal MD ...... 13 ...... 143 Chaudhry, Anu MD ...... 63 Coates-Wynn, Geoffrey MD .....72 Careplusrx Pharmacy ...... 235 Chaum, Edward MD ...... 103,145 Cobos, Rachel MD ...... 89 Careteam Plus Inc ...... 18 Chavez, Temujin MD ...... 54 Cogdell-Quick, Edna LPC ...... 176 Carey, Amanda SLP ...... 220 Cheatle, Joseph MD ...... 100 Cohen, Alexander MD ...... 2,7 Carmichael, Michael MD ...... 78 Chee, Julie MD ...... 13 Coker, James OD ...... 106 Carolina Care Medical Supply LLC Cheng, Vicki PT ...... 210 Cole, James PT ...... 210 ...... 143 Chernev, Ivan MD ...... 72 Coleman, Megan APRN ...... 168 Carolina Drug Store Inc ...... 233 Cherry Grove Drug ...... 238 Collette, David OD ...... 106 Carolina Forest Pharmacy ...... 238 Cheshire, Amanda MD ...... 39,59 Collier, Victor MD ...... 19 Carolina Health Pharmacy ...... 238 Chesterfield County Health Collins, Andrew APRN ...... 197 Carolina Healthcare Inc DBA Department ...... 134 Collins, Charles MD ...... 11 Compass Post ...... 147 Chesterfield Drug Company ....232 Collins, Diana APRN ...... 162 Carolina Orthotics And Prosthetic Chiarmonte, Anthony PT ...... 210 Of Myr ...... 147 Collins, Nancy MD ...... 21 Childrens Care Pharmacy ...... 138 Carolina Orthotics And Colon-Garcia, Patricia MD ...... 59 Prosthetics LLC ...... 147 Chinich, Caren CNP ...... 168 Colongarcia, Patricia MD ...... 39,99 Carolina Pharmacy ...... 241 Chitty, Nina PT ...... 210 Combs, Susan SLP ...... 220 Carolina Pines Regional Medical Choi, Gwen MD ...... 78 Comianos, Marc DO ...... 20 Center ...... 127 Chokshi, Rakesh MD ...... 69 Congdon, Karyn PT ...... 210 Carolina Sleep Diagnostics Inc Chowdhary, Deepak MD ...... 50 Coni, Robert DO ...... 99 ...... 136,140 Christensen, Tom MD ...... 13 Conner, Daniel DO ...... 2 Caron, Philip DO ...... 42 Christian LA Touche, Jeanine Conner, Gerald MD ...... 72 Carpenter, Lindsey APRN ...... 158 CRNA ...... 180 Conway Dialysis Ctr ...... 143 Carrera-Alvarez, Amanda MD .....111 Christiansen, Laura PT ...... 210 Conway Manor ...... 147 Carter, Kaycee CSW ...... 162 Chumble, Shubhangi MD ...... 39,59 Conway Medical Center ...... 130 Carter, Krystal LPC ...... 163 Ciancione, Jerome CRNA ...... 180 Conway Pharmacy ...... 238 Carter, Ralph MD ...... 123 Ciancione, Peter CRNA ...... 160 Cook, Helen APRN ...... 202 Carter, Robert LMFT ...... 189,190 Cicio, William MD ...... 95 Cook, Todd MD ...... 108,109 Carter, Shari CNP ...... 155 Circle Park Behavioral Health Cooler, Arthur MD ...... 31,32 Carter, Xaviera MD ...... 101 Services ...... 137 Cooper, Janet APRN ...... 152 Casley, Denise LPC ...... 163 Clark, Barry DO ...... 35 Cooper, Pansy APRN ...... 202 Caudle, Tory MD ...... 22 Clark, William MD ...... 65 Cooperman, Tyler PT ...... 210 Caugh, Kurtis OD ...... 106 Clarke, Cheryl MD ...... 42 Cora South Carolina ...... 147 Central Pharmacy ...... 234 Climer, Clyde MD ...... 42 Corey, Stephen DPM ...... 125 Cerasaro, Thomas MD ...... 115 Cline, Matthew DC ...... 38,83 Cornnell, Timothy MD ...... 87 Chadbourne, David MD ...... 78 Cluver, Jeffrey MD ...... 112 Corontzes, Stephen MD ...... 22 Chamberlain, Brooke NP ...... 75 Clyburn-Ipock, Virginia MD ...... 76 Corti, Sandro MD ...... 27,39,59 Chandler, Thomas MD ...... 112 Coastal Cancer Center Pharmacy Costco Pharmacies ...... 238 ...... 238 Chang, Eugene MD ...... 56 Cote, Lydia PA ...... 185 Chapman, Raymond MD ...... 4 Cotter, Priscilla SLP ...... 222

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Provider Index

C - cont. Daniel, Scott MD ...... 33 Dineen, Kevin MD ...... 113 Daniels, Frederick MD ...... 22 Dinello, Kaylee SLP ...... 220 Coughlin, Eric MD ...... 63 Daniels, Prezillic LPC ...... 163,176 Dipaolo, Zachary MD ...... 70,77 Courtney, Donald MD ...... 20 Danzey, Toya MD ...... 33 Ditsious, Jaenell APRN ...... 202 Covington, Al OD ...... 28 Darlington County Health Dixon, Heather OT ...... 207 Coward, Jacob APRN ...... 156 Department ...... 135 Docherty Jr, Jon MD ...... 76 Cowsar, Paul APRN ...... 202 Darlington Dialysis Ctr ...... 135 Doctors Care ...... 140 Cox, Demeatra LPC ...... 191 Darlington Family Pharmacy .....233 Doherty, Meghan OT ...... 207 Cox, Jesse MD ...... 57 Dave, Sejal MD ...... 53 Dominique, Devanand MD ...... 63 Crago, Ashley APRN ...... 197 Davidson, James MD ...... 63,64 Donato, Eduardo MD ...... 10 Crawford, Anita APRN ...... 153 Davis Boyd, Tara APRN ...... 197 Dorr, Rachel APRN ...... 198 Crawford, Rebecca APRN ...... 225 Davis, Nancy LPC ...... 191 Dorr, Rachel NP ...... 21 Crawford, Stephanie APRN .....202 Davis, Richard MD ...... 4,11 Dorton, Kathy PT ...... 211 Creson, Stuart OD ...... 106 Davis, Rochelle LCSW ...... 181,182 Dougherty, Joseph MD ...... 38 Cress, Lyndsi DO ...... 13 Davis, William MD ...... 2 Douglas, Danny MD ...... 45,81 Cribb, Shannon APRN ...... 197 Dawson, Michelle SLP ...... 223 Dozier, Samuel MD ...... 54 Crickman, Bonnie MD ...... 31,48 Dean, Mark OD ...... 106 Drucker Drugs And Medical Crisp, Brian PA ...... 173 Deblasi, Lori DPM ...... 73 Equipment ...... 151 Crosby, Thomas MD ...... 26 Debsikdar, Jaideep MD ...... 45 Dukes, Laura PT ...... 211 Crossway Medical ...... 138 Deeney, Michelle PA ...... 225 Duncan V, Scott MD ...... 92,109 Crouch, Timothy MD ...... 45 Degrood, Robert MD ...... 121 Duncan, Anna DO ...... 25 Crowell, Jacqueline APRN ...... 197 Demarco, Donna PT ...... 210 Dundee Manor ...... 150 Crowninshield, Jessica SLP ...... 220 Demarco, Paul MD ...... 54,121 Dunn, Kathleen MD ...... 101 Crum, Christopher APRN ...197,202 Denittis, Felicia PA ...... 196 Durant, Kelvin LPC ...... 163,176 Csc Community Pharmacy Mccoll Denlinger, Chadrick MD ...... 114 Durst, John MD ...... 43 ...... 242 Dennis, Brandi LPC ...... 163,191 Durst, Kimberly PT ...... 211 Csc Community Pharmacy 232,233 Denton, Patrick MD ...... 35,37,69,77 Dyce, Orville MD ...... 30 Csc Community Pharmacy-Latta Deshmukh, Ashwin MD ...... 70 ...... 234 E Deshon, Laurie PA ...... 217 Csc Community Eames, Lacey DO ...... 101 Destefano, Ellen PT ...... 211 Pharmacy-Society Hill ...... 233 Eastep, Alyson CRNA ...... 160 Dewitt, Melissa LPC ...... 154 Csc Community Phcy Eaton, Carol PA ...... 181 Dhadwal, Neetu MD ...... 39,59 Bennettsville ...... 242 Eaton, Richard MD ...... 13 Diamond, Jason OD ...... 106 Cuddy, Brian MD ...... 100,144 Ebama, Nyabilondi MD ...... 93,95 Dickinson, Elizabeth MD ...... 31,48 Cuff, Ryan MD ...... 56,63 Eck, Dustin MD ...... 51,72 Dickinson, Thomas MD ...... 2,7 Culleton, John MD ...... 48 Eddins, Stefani LCSW ...... 158 Didelot, William MD ...... 109 Cumbie, Heather PT ...... 210 Edgar, Kenneth MD ...... 32,62 Didolkar, Parijat MD ...... 115 Cunningham, Christopher MD Edmison, John MD ...... 87 Dieter, Sara PT ...... 207 ...... 77,114 Edmison, Lacie MD ...... 95 Dietz, Teresa APRN ...... 158 Curl, Anita APRN ...... 169 Edosomwan, Emmanuel MD ...... 1 Dillon Community Pharmacy .. 234 Cusack, Shemeka SLP ...... 220 Edwards II, Ira DC ...... 46,83,84 Dillon County Health Department Czepowicz, Violetta MD ...... 81,112 Edwards III, George PA ...... 175 ...... 136 Edwards, Erin ARNP ...... 198 D Dillon Family Pharmacy ...... 234 Edwards, Willie MD ...... 70 Dameron, Jason MD ...... 27,32 Dimkpa, Rajeshree MD ...... 27 Egan, Brad OT ...... 207

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Provider Index

E - cont. Fam, Nabil MD ...... 51 Flowers, Stephen OD ...... 34 Family Care Medical Supply ..... 144 Floyd Brace Company Inc ...... 147 Eggart, Malcolm MD ...... 100 Family First Support Center ..... 136 Floyd Norris, Iris MD ...... 121 Eglen, Rebecca MD ...... 22 Farley, Colleen APRN ...... 203 Floyd, Cassie APRN ...... 203 Einziger, Samantha OT ...... 172 Farnill, Leslie OT ...... 207 Floyd, Cecil MD ...... 51 Eisenman, Richard MD ...... 87 Farrah, Jason MD ...... 89 Floyd, Erin PA ...... 217 Elder, Benjamin MD ...... 11 Farrell, Howard MD ...... 47 Floyd, James MD ...... 14 Elder, Robert MD ...... 2 Feagin, Brian OT ...... 173 Floyd, Jessica MD ...... 40,59 Elder, Sherry APRN ...... 168 Feaker Jr, David DO ...... 70 Floyd, Whitney PT ...... 173 Elkins, Jennifer LPC ...... 163 Felder, Melissa APRN ...... 168 Fmc Dialysis Pee Dee Dialysis Ctr Elliott, Alexis LSW ...... 182,189 Feliciano, Carlos MD ...... 39,59 ...... 138 Elliott, Rebecca SLP ...... 227 Fenner, Lynda LCSW ...... 187 Fmc Dialysis Svcs Hartsville ...... 135 Ellis, Richard MD ...... 26 Ferguson, Kimberly SLP ...... 223 Fmc Dialysis Svcs Murrells Inlet 143 Ellison, Beatrice LPC ...... 152 Ferguson, Naomi ARNP ...... 203 Fmc Dialysis Svcs N Myrtle Beach Ellison, Thomas MD ...... 109 Ferranti, Vincenzo PT ...... 211 ...... 143 Elms, John MD ...... 98 Ferrigno, Michael DC ...... 46 Fmc Freedom Dialysis ...... 138 Elraie, Khaled MD ...... 87,88 Ferrigno, Michelle APRN ...... 162 Fogarty, James DO ...... 115,116 Elya, Marwan MD ...... 75 Figueroa Garcia, Alberto MD Fontanares, Roland PT ...... 211 Emerson, Gary MD ...... 64 ...... 40,59,99 Foreman, Thomas MD ...... 89 Emerson, Jammie APRN ...... 203 Finch, Carole PA ...... 175 Forrest, James CRNA ...... 180 English, Wynne MD ...... 177 Fink, Jessica DPM ...... 73 Fortune, Jane LPC ...... 191,192 Epperson, William MD ...... 13,14 Finklea, Kitty RD ...... 172 Foster, Karen PT ...... 211 Epstein, Aaron MD ...... 89 Finley, Erin PA ...... 217 Fowler Pharmacy ...... 150,242 Etheridge, Martin LPC ...... 152 Finneran, Matthew MD ...... 56,64 Fowler, Tiffany APRN ...... 180 Evans, Brian MD ...... 78 Firilas, Anthony MD ...... 84,144 Francke, Patrick MD ...... 113 Evans, Jeffrey DC ...... 84 First Choice Medical Respiratory Frank, Walter MD ...... 116 Evans, John DC ...... 84 Servic ...... 144 Frasier, Colisha LPC ...... 192 Evans, Kerri APRN ...... 203 Fishburne, Barron MD ...... 33 Freel, Paul MD ...... 6 Evans, Lauren APRN ...... 203 Fisher, Sierra APRN ...... 168 Freeman, Gil MD ...... 35 Evans, Patricia LPC ...... 152 Fitzgerald, John PT ...... 211 Freeman, Katherine APRN .182,203 Evans, Tonya SLP ...... 223 Fitzgibbon, Timothy MD ...... 6 French, John MD ...... 28 Evans, Walter MD ...... 59 Fitzpatrick, Christine SLP ...... 220 Fresenius Kidney Care Black Creek Everhart Lachnicht, Ashley LPC 191 Flanegan, Renee APRN ...... 203 Dialys ...... 135 Everman, Anne MD ...... 81 Fleming, Stephanie LPC ...... 191 Fresenius Kidney Care Florence Executor Diagnostics LLC ...... 140 Florence Brace And Limb Inc ...140 Home ...... 138 Express Medical Equipment Inc Florence County Health Fresenius Kidney Care Florence ...... 144 Department ...... 137 Medical M ...... 138 Eyemart Express LLC ...... 67,104 Florence Home Care Services LLC Fresenius Med Care Bennettsville Eyes Over Carolina PC ...... 33,34 ...... 139 ...... 150 F Florence Primary Eyecare PC .....67 Fresenius Med Care Church St 138 F & L Drug Store ...... 235 Florence Surgery And Laser Fresenius Med Care Dillon ...... 136 Faile, Kenneth MD ...... 7 Center LLC ...... 137 Fresenius Med Care Florence Faiyaz, Seema MD ...... 43 Florence Visiting Nurses Service Dialysis ...... 138 Falk, Mitchell DC ...... 121 Inc ...... 139

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Provider Index

F - cont. Gibson, Elizabeth PT ...... 211 Grande Dunes Surgery Center . 141 Gibson, Robin LPC ...... 154 Grant, Lisa PT ...... 212 Fresenius Med Care Johnsonville Giddens, Eugene MD ...... 101 Grasshoff, Victoria SLP ...... 177 ...... 138 Gilmore, Pamela APRN ...... 198 Gray Stanley, Tommi AUD ...... 179 Fresenius Med Care Kingstree ...151 Gilpin, Albert MD ...... 70 Greeleyville Pharmacy ...... 243 Fresenius Med Care Marion .....149 Gittens, David DC ...... 47 Greenan, Candice MD ...... 64 Fresenius Med Care Myrtle Beach Glaser, Jacob MD ...... 89 Greene, Howard MD ...... 33,65,103 ...... 143 Glinski, Ronald MD ...... 78 Greer, William MD ...... 109 Fresenius Med Care West Conway ...... 143 Glover, Farrah SLP ...... 221 Griesmer, Brendan MD ...... 20 Friedman, Mark DO ...... 40,60 Glover, Mary MD ...... 84 Griffith, Mary APRN ...... 198 Frye, Amanda SLP ...... 221 Gluzberg, Tatyana MD ...... 14,144 Grimsley, Jessica APRN ...... 231 Frye, Fritz PA ...... 217 Gobin, Mark DO ...... 20 Grinman, Mark MD ...... 99 Fukuda, Christopher MD ...... 44,78 Godwin, Ashton APRN ...... 170 Gross, Jeffrey MD ...... 33 Fulcher, Rosanne LPC ...... 164 Goebel, Jason MD ...... 81 Growing Home Southeast ...... 137 Fuller, Clara LPC ...... 164,177 Goings, Charity SLP ...... 221 Grubb, Larry MD ...... 76 Fulmore, Carolyn LPC ...... 158 Goldberg, Renwick MD ...... 93 Grubb, Stephen MD ...... 14 Fulton, Melissa LPC ...... 231 Golden Town Pharmacy ...... 238 Gude, Adam CNP ...... 168 Fulwood, Karen APRN ...... 155,169 Goldstein, Lewis MD ...... 64 Guha, Prabal MD ...... 30,45 Gonzales Acevado, Camille LPC Guidry, Christopher MD ...... 51 G ...... 164 Gulledge, Paul APRN ...... 227,231 Gaddy, Mckethan OD ...... 44 Good, Edward MD ...... 60 Gulledge, Paul ARNP ...... 231 Gainey, Cynthia APRN ...... 169 Goodall, Kristina LPC ...... 192 Gupta, Raina MD ...... 40,60 Gainey, Shannon APRN ...... 153 Goodier, Christopher MD ...... 56 Gusic, Brittany MD ...... 14 Gajewski, Timothy MD ...... 116,122 Goodroe, Randall MD ...... 81,82,95 Gwyer, Carrie APRN ...... 185,186 Gal, Almog MD ...... 20 Goodson, James MD ...... 65 H Gallier, Catherine APRN ...... 203 Goodwin, Misty LPC ...... 164 Hadstate, James MD ...... 97,98 Gamble, Natalie LPC ...... 164,231 Gopalakrishnan, Parakkat MD ....121 Haenel, Louis DO ...... 86 Gammon, William MD ...... 14 Gore, Rezell LCSW ...... 228 Hafenbreidel, Jill OT ...... 207 Gangi, Glenn MD ...... 116,117 Govindappa, Venugopal MD Ganley, Tracey APRN ...... 200 ...... 32,36,54,57 Hagan, Timothy MD ...... 62 Gardache, Marissa PA ...... 217 Goyeneche, Paola LPC ...... 192 Hahn, Kelly APRN ...... 198 Gardner, Carol APRN ...... 204 Grady, Cynthia MD ...... 102,145 Haire, Aaron DPM ...... 73 Garland, Frederick DPM ...... 111 Graham, Almeda APRN ...... 170 Hall, Megan DO ...... 111 Garner, James MD ...... 24 Graham, Carrie LPC ...... 164 Hallock, Irene CNP ...... 204 Garrett, Nicole PA ...... 186 Graham, Elizabeth LPC ...... 164 Hamer, Melissa APRN ...... 168 Garris, Theressa ARNP ...... 168 Graham, Lauri OD ...... 106 Hamilton, Cynthia APRN ...... 204 Gause, John MD ...... 51 Graham, Martha LPC ...... 154 Hamilton, Frederick DO ...... 122 Gelb, Ernest DO ...... 14 Graham, Megan PT ...... 212 Hancock, Amy PA ...... 217 George, Linda APRN ...... 156 Graham, Meridith CSW ...... 231 Hanger Clinic ...... 138,140 Gersch, Karen MD ...... 114 Graham, Rochelle LPC ...... 154 Hanger Prosthetics & Orthotics ...... 138 Ghorra, Salim MD ...... 27 Graham, Toney MD ...... 11 Hanna, Charlotte PA ...... 175 Gibbons, Laura SLP ...... 221 Grainger, Terry MD ...... 30 Hanna, Rebekah APRN ...... 231 Gibbs, Ashley APRN ...... 204 Grand Strand Regional Medical Hardee, Chelsea APRN ...... 170 Gibbs, Sean MD ...... 14 Center ...... 130 Hardee, Joseph PA ...... 160,179

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Provider Index

H - cont. Heimberger, Eric MD ...... 109 Howington, Bryan MD ...... 31,48 Heineck, Robert MD ...... 102 Hsia, Michael MD ...... 79 Hardee, Katherine OT ...... 207 Heller, Adam MD ...... 40,60 Huber, Stephen MD ...... 78 Harden, Sonya CNM ...... 206 Hemingway, Jenica DC ...... 84 Hucks, Julia APRN ...... 198 Harding, Mary APRN ...... 204 Hemingway, Shauna MD ...... 64 Hucks, Mark MD ...... 64 Harford, Janelle MD ...... 102 Hempton, Brittany NP ...... 57 Hudley, Jamila SLP ...... 177 Harlan, Joseph MD ...... 57 Henderson, Jordan DO ...... 93 Huggins, Lauren PT ...... 174 Harless, Michael MD ...... 2 Heniford, Mary PT ...... 212 Hughes, Chelsea MD ...... 43 Harley, Jessica PA ...... 217 Hernandez, Jose MD ...... 88,96 Hughes, Farrah PHD ...... 74 Harling, Michael MD ...... 27 Herrington, Susan PA ...... 218 Huiet, Christopher PA ...... 173 Harmon, Gerald MD ...... 14 Hershberger, Corey PT ...... 212 Hunter, Lauren SLP ...... 223 Harmon, Tonya SLP ...... 223 Hess, Lori MD ...... 15 Hunter, William PSYD ...... 74 Harper, Phillip LPC ...... 192 Hewitt, Brenda APRN ...... 204 Hutcheson, Brian DC ...... 47 Harrah, Jason MD ...... 14 Hewitt, Carolina APRN ...... 170 Huynh, Donny MD ...... 53,54,93,96 Harrell, Ashley APRN ...... 168 Heyward, James PT ...... 174 Hyer, Eric PT ...... 212,213 Harrington, Teressa LPC ...... 192 Hicks, Ashley MD ...... 8 Hypes, Stephen DO ...... 66 Harris, James MD ...... 51 Hicks, John MD ...... 82 Harris, Larry PA ...... 181,217 I Hightower, Stephanie APRN ...204 Harris, Lu Etta AUD ...... 160 Ignacio, Iris MD ...... 8 Hill, James APRN ...... 162 Harrold, Bernadette CRNA ...... 180 Imbeau, Nancy PT ...... 174,229 Hill, Karen MD ...... 11 Harseys Pharmacy ...... 232 Imbeau, Stephen MD ...... 45 Hinman, Candace PA ...... 185 Harts Dialysis ...... 135 Incare Home Health ...... 146 Hite, Stephanie PT ...... 212 Hartsville Drug Company Inc ...233 Incare Medical Equipment Myrtle Hobbs, Steven OD ...... 68 Hartzog, Timothy MD ...... 72 Beach ...... 144 Hodge, Michael MD ...... 60 Harvey, Andre LCSW ...... 158 Ingram, Irene OT ...... 156 Hoffman, Michael MD ...... 28,43,123 Harvey, Shannon OD ...... 68 Inmed Diagnostic Services Of Sc Hoffmeyer, Margaret MD ...... 8 Haseltine, David MD ...... 95 LLC ...... 137,138,142 Holland, Evans MD ...... 46 Haskill Strowd, Rebecca MD ...... 8 Itani, Najla MD ...... 96 Holley Jr, Charles MD ...... 78 Hassan, Alkhatib MD ...... 95 Ittenbach, Dennis PT ...... 213 Holmes, Essie SLP ...... 231 Hassler, Terence MD ...... 35 Ivy, Amy ...... 223 Holmes, Regina APRN ...... 204 Hauberg, Julie PT ...... 212 Holt, Monica APRN ...... 162 J Haughton, Michael MD ...... 93,98 Holt, Raymond MD ...... 15 Jackel, Lisa PHD ...... 74 Hayek, Hafez MD ...... 113 Hood, Teresia LSW ...... 153,154 Jackson, Debbie CSW ...... 187 Hazelwood, William MD ...... 75,122 Hopla, Dan MD ...... 47 Jackson, Haley APRN ...... 156 Head, Barbara MD ...... 64 Horchak, Alex MD ...... 79 Jackson, Kimberly APRN ...... 200 Health Care Partners Phcy Marion Horger, David MD ...... 37 Jackson, Kimberly MD ...... 8 ...... 241 Horry County Commission On Jackson, Tamiko APRN ...... 179 Healthcare Partners Of Sc ...... 238 Alcohol Drug ...... 141 Jackson, William MD ...... 82 Healthpro Heritage Rehab And Horry County Health Department Jackson-Dozier, Focell MD ...... 8 Fitness LLC ...... 140 ...... 141 Jaggers, Terri MD ...... 50 Healthsouth Rehabilitation Hotaling, Ashleigh APRN ...... 204 Jain, Vasudha MD ...... 15 Hospital Of F ...... 140 Howard, Thomas MD ...... 86 James, Kiasha MD ...... 48 Healy Jr, Robert MD ...... 60 Howard, Vanessa APRN ...... 198 James, Paul APRN ...... 204 Heaster, Brian MD ...... 4,10 Howell, Richard MD ...... 8 Jansen, Robert MD ...... 117 Heilman, D'andra. PT ...... 212

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Provider Index

J - cont. Joyner, Debra PA ...... 225 Knight, Aimee LPC ...... 164 Knippen, Elizabeth PA ...... 175 Japitana, Marian MD ...... 4 K Kocherla, Cyrus MD ...... 45,55 Jasper, Kendell PHD ...... 44 K J Pharmacy 129 ...... 138 Koike, Jun MD ...... 102,145 Jebaily, Deann DO ...... 48 Kahn, David LCSW ...... 164 Kolb, Cynthia MD .28,43,64,102,123 Jebaily, Gerard MD ...... 8 Kahn, David LPC ...... 154 Kontos, Jimmy MD ...... 82 Jebaily, Nicholas MD ...... 82 Kaminski, Daniel PT ...... 213 Kozel-Diamond, Sandra OD .....106 Jebaily, Patrick MD ...... 8 Kamouh, Abdallah MD ...... 54 Krauss, Kari OT ...... 207 Jefferson Drug ...... 232 Karanam, Karthik MD ...... 55 Kroger Drugstore ...... 238 Jefferson, Samantha LPC ...... 164 Karavan, Mark MD ...... 82,96 Kroger Pharmacy ...... 238 Jenkins, Cynthia LPC ...... 227 Karl, John MD ...... 15 Kroger Sav-On ...... 238 Jennings, Jennifer PT ...... 213 Karrowni, Wassef MD ...... 46 Krozer, Steven APRN ...... 156 Jimenez-Sanders, Rebecca MD Karth, Peter MD ...... 33 Krutke, Amanda CNP ...... 186 ...... 40,60 Kasitz, Jesse APRN ...... 171 Kunz, Rachel PT ...... 213 John Deloaceh ...... 192 Kass, Robin MD ...... 60 Johnson, Alan MD ...... 89,114 Kayan, Sabih MD ...... 36 L Johnson, Bruce MD ...... 71 Keefer, Adam MD ...... 119 Labcorp ...... 133,140,146 Johnson, Damien LPC ...... 230 Keenan, Robert MD ...... 76 Laboratory Corp Of America Johnson, David MD ...... 20,66 Keeton, Janis MD ...... 43 ...... 140,151 Johnson, David OD ...... 123 Keisler, Lydia MD ...... 102 Lagares-Garcia, Jorge MD ...... 84 Johnson, Denise APRN ...... 170 Keith, John MD ...... 4,12 Lake City Community Hospital 129 Johnson, Donna MD ...... 56 Kellahan, Meredith SLP ...... 221 Lamar Family Pharmacy ...... 233 Johnson, Edward OD ...... 124 Kelley Corners Dialysis ...... 138 Lamar, Cory MD ...... 40,60 Johnson, Katy PA ...... 179,186 Kelley, Jill LPC ...... 154 Lamb, Benjamin MD ...... 8 Johnson, Nancy APRN ...... 204 Kelly, James MD ...... 6 Landers, Summer PA ...... 181,218 Johnson, Nia SLP ...... 221 Kelly, Kathleen CSW ...... 187 Lang, Yolanda APRN ...... 199 Johnson, Sharon APRN ...... 155 Kelly, Nanette APRN ...... 205 Langley, Laura LPC ...... 164 Johnston, Virginia APRN ...... 179 Kemp, Faron MD ...... 96 Lanning Lowther, Lisa DO ...... 31,48 Jona, Vinod MD ...... 75,113 Kershaw County Commission On Lary, Andrea SLP ...... 223 Jones Brown, Jacqueline SLP .... 221 Alcohol And ...... 134 Laspada, Raymond PT ...... 213 Jones Family Eyecare PC ...... 34 Kershner, Elizabeth LCSW ...... 153 Lasry, Valerie MD ...... 102 Jones, Gregory MD ...... 77 Khan, Sanaulla MD ...... 36 Latta Drug Co Inc ...... 234 Jones, Jordi OD ...... 34 Khishchenko, Natan MD . 27,40,99 Lawrence, Emily SLP ...... 221 Jones, Karen CRNA ...... 160,180 Khoury, George MD ...... 101,144 Lawrence, Melanie APRN ...... 226 Jones, Keith OD ...... 34 Kight, Paige APRN ...... 171,172 Lawrimore, Cynthia APRN ...... 170 Jones, Michelle SLP ...... 221 King, Ellen LPC ...... 192 Leask, Gavin MD ...... 82,83 Jones, Nathan MD ...... 84,85 King, Gregory MD ...... 66 Lee, Alexandria AUD ...... 179 Jones, Stephen MD ...... 43 King, Merritt MD ...... 102 Lee, Amanda OD ...... 106 Jones, Trisha CRNA ...... 160 Kirby, Deborah MD ...... 60 Lee, Frank MD ...... 51 Jordan, Chucky DC ...... 47 Kirby, Lesley AUD ...... 153,160 Lee, Hope PA ...... 175 Jordan, Ginger APRN ...... 199 Kirkland, Marion LPC ...... 178 Lee, James MD ...... 46 Jordan, Henry MD ...... 123 Kirven, Lauren APRN ...... 170 Lee, Jason OD ...... 68 Jordan, Meghan MD ...... 11,12 Kjs Pharmacy 129 ...... 235 Lee, Jennifer APRN ...... 205 Jordan, Robert MD ...... 85 Kleess, Lauren MD ...... 86 Lee, Jessica MD ...... 85 Joslin, Richard MD ...... 15 Kline, Daniel PT ...... 213 Lee, Matthew PT ...... 214

www.wellcare.com/South-Carolina | 268 38642781

Provider Index

L - cont. Loomis, Alexandra PA ...... 218 Mannain, Taanya LSW Lorenz, William MD ...... 72 ...... 182,183,195,196 Lee, Misty DPM ...... 73 Loris Dialysis Ctr ...... 143 Maqsood, Farhan MD ...... 4,55 Lee, Wendy MD ...... 114 Loris Drug Store ...... 238 Marchase, Nicholas MD ...... 103 Lehman, Annie SLP ...... 221 Loving Arms Home Care LLC .. 139 Marion County Health Leisy, Heather MD ...... 73 Low Country Home Medical Department ...... 149 Leith-Fischer, Madeleine SS ...... 125 Equipment Co In ...... 139 Marion County Medical Center Lemon, Edward OD ...... 34,68 Lowcountry Pharmacy LLC ...... 235 ...... 149 Leninger, Katherine SLP ...... 223 Lowcountry Pharmacy ...... 139 Market Commons Dialysis Center Levenson, Terry MD ...... 21,22 Lowe, Ashley ARNP ...... 155 ...... 143 Levy, Marissa AUD ...... 179 Lowe, Lisa SLP ...... 223 Marlboro County Health Lew, Michael MD ...... 90 Lownsberry, Erick LPC ...... 165 Department ...... 150 Lewis, Jesse MD ...... 109 Lu, Rommel MD ...... 53 Marlboro Drug Company ...... 242 Lewis, John PA ...... 218 Ludlow, Donald MD ...... 22,23 Maroney, Constance MD ...... 10 Lewis, Katie OT ...... 208 Lue, Stanley MD ...... 40,60 Martin, John LPC ...... 165 Lewis, Kellie CSW ...... 187 Lukowski, David MD ...... 92,109 Martin, Laura LPC ...... 193 Li, Mian MD ...... 60 Lukowski, Jessica MD ...... 22 Martin, Patrick DC ...... 84 Li, Sui MD ...... 27,40,60 Lukowski, Peter MD ...... 109 Martin, William MD ...... 2 Lieberman, Ariane MD ...... 124 Lusk, Clifford MD ...... 43,65 Martinez, Eduardo MD ...... 102 Life Altering Behavioral Health Lynch, Bruce LPC ...... 193 Maselli, Lisa MD ...... 102 Services ...... 137 Lynch, Nancy PT ...... 214 Mason, Rachel SLP ...... 227 Lilly, Brandon MD ...... 112 Lynn, Christina MD ...... 112 Masud, Muhammad MD ...... 40,60 Lilly, Douglass MD ...... 2 Lynn, Deborah LPC ...... 154 Mathisuthan, Gangatharan MD 122 Lincare Inc ...... 136,139,144,149,151 Lyons Prosthetics And Orthotics Mattheis, John MD ...... 8 Lincare ...... 138,144 ...... 147 Matthews, Kara APRN ...... 205 Lindaberry, Jeffrey DO ...... 15 Lyons, Ruth LCSW ...... 187 Matthews, Kimberly CRNA ...... 161 Lindsay, Christine APRN ...... 199 Lyttle, Deanna MD ...... 66 Matzinger, Steven MD ...... 90 Lineback, Bradley MD ...... 22 M Mauldin, Kristen PA ...... 181 Linkia ...... 139 Maybin, Ashley MD ...... 111 Little River Medical Center .. 18,145 M & D Drug Company ...... 235 Mayeaux II, Eugene MD ...... 18 Little River Medical Ctr Phcy .. 238 Macaluso, Sherry LPC ...... 165 Mazgaj, Jamie LPC ...... 165 Little, Earline APRN ...... 229 Macdonald, Allan MD ...... 8 Mcabee, Andrew PT ...... 174 Little, Elizabeth SLP ...... 177 Mace, Alexandra PT ...... 214 Mcafee, Leticia SLP ...... 223 Litts, Christopher MD ..32,36,52,70 Mack, Aimar MD ...... 38 Mcbride, Karen SLP ...... 177 Litts, Patricia MD ...... 64 Magera, Barbara MD ...... 124 Mccaffrey, Michael MD ...... 99 Lloyd, Quincey SLP ...... 223 Mahaffey, Kathryn SLP ...... 223 Mccann, Michael DPM ...... 73 Lobo, Vanessa LPC ...... 165 Maksin, Michael PA ...... 175 Mccarthy, Robert LPC ...... 193 Locklear-Batton, Ashley DO ...... 15 Malkasian, Loren LPC ...... 193 Mccauley, Chris MD ...... 103 Long, Kristina PA ...... 218 Malkasian, Paul LPC ...... 193 Mcclain, Nicole PT ...... 174 Long, Shannon LPC ...... 192 Malone, Meghan MD ...... 88 Mcclam, Andrea LPC ...... 165 Long, William MD ...... 2 Malone, Michael MD ...... 15 Mcclary, Guy MD ...... 9 Longan, Anita RD ...... 172 Maloney, Kelly MD ...... 79 Mccoll Dialysis ...... 150 Longs Dialysis ...... 143 Malvarosa, Paul LPC ...... 163 Mccrae, Allison MD ...... 90 Longs Drug ...... 235 Mangano, Andrew DO ...... 20 Mcdaniel, Anita LPC ...... 165 Lookadoo, Brian LPC ...... 192,193

www.wellcare.com/South-Carolina | 269 38642781

Provider Index

M - cont. Messier Jr, Robert MD ...... 78 Montes, Antonio PT ...... 159 Meyer, Stephen MD ...... 96 Moody, Ashley PA ...... 178 Mcdonald, Mark MD ...... 40,61,99 Meyers, Clifford MD ...... 41,61 Moore, Adele CNP ...... 181,199 Mcdougal, Patrick ARNP ...... 170 Mezzanotte, Thomas MD ...... 70 Moore, Barry MD ...... 112 Mcdowell, James OD ...... 29 Mezzatesta, Patricia SLP ...... 224 Moore, Casey APRN ...... 156 Mcfadden, Sherrlyn APRN ...... 168 Mgb Eyes Inc ...... 104 Moore, Christopher LPC ...... 177 Mcfarland, Lindsey CSW ...... 187 Miara, Melissa DO ...... 96,113 Moore, Dorwin MD ...... 43 Mcgonigal, Jennifer LPC ...... 193,194 Middleton, Jessica PA ...... 218 Moore, Ellen MD ...... 10 Mcinnis, James MD ...... 3,10 Mijalli, Mamdouh MD ...... 90 Moore, Robert MD ...... 52 Mcintyre, Alex MD ...... 90,114 Mikol, Edward MD ...... 109 Morando, Donald DO ...... 15,16 Mckay, Shawn MD ...... 47 Militano, Ulises MD ...... 70 Morgan, Patrick MD ...... 49 Mcknight, Deloris LPC ...... 165 Miller, Ashley APRN ...... 206 Morgan, Ross MD ...... 110 Mckoy, Alexia ARNP ...... 229 Miller, Johnathan PA ...... 219 Morjain, Jessica DO ...... 20 Mclaughlin, Matthew DO ...... 96 Miller, Michelle APRN ...... 168 Morphis, Elizabeth MD ...... 4,5 Mcleod Cardiothoracic Vascular Mills, Michael OD ...... 107 Morphis, James MD ...... 4 Surgical ...... 137 Mills, Timothy MD ...... 15 Morris, Angela APRN ...... 231 Mcleod Choice Phcy Seacoast Mims, Albert MD ...... 9,26 Morris, Judy NP ...... 9 ...... 238 Mims, Teresa OT ...... 208 Moscatello, Salvatore DO ...... 50 Mcleod Health Cheraw ...... 126 Mincey, Kenneth MD ...... 51,90 Moses, Timothy MD ...... 79 Mcleod Loris Seacoast Ho ...... 130 Mincheff, Thomas MD ...... 32 Moskos, Frank MD ...... 49 Mcleod Medica Center Darlington ...... 127 Minter, Andrea SLP ...... 224 Motilal Nehru, Vijeyaluxmy MD ...... 53,55 Mcleod Medical Center Dillon 128 Minter, Ellen Patrice MD ...... 12 Mottey, Kristen CSW ...... 190 Mcleod Outpatient Pharmacy 235 Minuteclinic Diagnostic South Carolina ...... 141,142 Mowzoon, Mina MD ...... 41 Mcleod Regional Medical Center ...... 129,140 Minuteclinic LLC ...... 142 Mowzoon, Nima MD ...... 61 Mcleod, Casey APRN ...... 156 Miranda, Roberto MD ...... 49 Moyer, Joseph MD ...... 45,81 Mctavish, Joseph PA ...... 181,219 Mishra, Ellen ARNP ...... 228,229 Muldrow, Javonnia LPC ...... 165 Mczeke, Kathryn APRN ...... 196 Mislowsky, Angela MD ...... 90 Mullaney, Courtney CRNA ...... 180 Medcare Pharmacy ...... 242 Mitchell, Benjamin MD ...... 38 Mullins Discount Drug ...... 241 Medi Home Care ...... 139 Mitchell, Benjamin PA ...... 175 Munson Matthew, Megan LPC 165 Medicine Mart ...... 235,239 Mitchell, Edwin OD ...... 34 Muntean, Dan MD ...... 16 Mednick, Adam MD ...... 40,61 Mitchell, Melissa CRNA ...... 161 Murdaugh, Monica SLP ...... 224 Mehari, Tigist MD ...... 28,61 Modi, Nikunjkumar MD ...... 73 Muresan, Horatiu MD ...... 111 Meixel, Steven MD ...... 15 Moeckel, Douglas MD ...... 57 Murphy, David MD ...... 16 Melgar, Tammy PA ...... 218 Mogy, Catherine CRNA ...... 161 Murphy, Thomas MD ...... 81 Mendelson, Joshua MD ..... 28,41,99 Mohr III, Richard MD ...... 9 Murray, David LPC ...... 219 Mendez, Luz MD ...... 3 Mohr, Richard MD ...... 9,31,49 Murrell, Amy MD ...... 51 Mendoza Olivero, Isabel MD ...... 3 Mojumder, Deb MD ...... 41,61 Murtaza, Amir MD ...... 28,41 Menser, Cheryl APRN ...... 205 Moleins, Dawn APRN ...... 199 Musc Childrens Pediatrics Marion Medical ...... 24 Mercer, Amanda LPC ...... 194 Molter, Darron MD ...... 15 Musc Childrens Pee Dee Merhi, Eva OD ...... 106 Momentum Medical Brace And Limb ...... 149 Pediatrics Marion ...... 24 Merriman, Lisa SLP ...... 221 Monday, Michelle OT ...... 208 Musc Health Florence Medical Merritt, Rhonda OT ...... 208 Montenery, Jason PT ...... 214 Center ...... 129 Meseck, Michael PT ...... 214

www.wellcare.com/South-Carolina | 270 38642781

Provider Index

M - cont. Nuwayhid, Zaher MD ...... 91 Palmetto Breathing Solutions Nyes Pharmacy ...... 239 ...... 135,233 Musc Health Lake City Imaging Palmetto Diabetic Center ...... 139 Center ...... 137 O Palmetto Imaging Inc DBA Musc Health Marion Medical O'dell, Jason MD ...... 36,70 Florence MRI ...... 138 Center ...... 131 O'kelly, James MD ...... 79,122 Palmetto Infusion Services LLC Musc Health Mullins Nursing Ocean Lakes Pharmacy ...... 239 ...... 139 Center ...... 149 Odin, Alto DO ...... 6 Palmetto Infusion Services Myrtle Musc Health Primary Care Marion Odom, John MD ...... 24 Beach ...... 144,146 ...... 24 Oduwole, Adedapo MD ...... 112 Palmetto Infusion Services ...... 139 Musc Health Primary Care Mullins Oeffinger, Rebecca CSW ...... 162 Palmetto Prescription Center .235 ...... 24 Offenback, Richard PA ...... 218 Palmetto Prosthetics And Myers, Jocelyn MD ...... 10 Offiong, Dominic MD ...... 122 Orthotics Inc ...... 135,140 Myers, William MD ...... 111 Ogunfowora, Ayodele MD ...... 29 Palmetto Sleep Lab LLC Myrtle Beach Dialysis ...... 143 Okelly, Peter MD ...... 79 ...... 140,147,148 N Okoh, Samuel MD ...... 32,55,58 Palutsis, Gregory MD ...... 71 Nagabandi, Shashikanth MD ..... 96 Olatosi, Akinwale MD ...... 54 Pamplico Pharmacy ...... 235 Nagaraja, Harsha MD ...... 41,61 Oliver, Elizabeth SLP ...... 224 Pande, Amit MD ...... 83 Nambudiri, Vinod MD ...... 20,85 Om, Anil MD ...... 46 Pande, Meenakshi MD ...... 48 Nance, Clyde LPC ...... 165 Omnicare Of Florence ...... 235 Pandoo, Justin MD ...... 20 Naso, Nicolette MD ...... 46 Oneal, Joseph PA ...... 157 Panicker, Jaison OD ...... 35 Natarajan, Sundar MD ...... 124 Onley Livingston, Angel LPC ....194 Pannu, Davinderbir MD ...... 50 Naylor, Brian MD ...... 12 Oquinn, Georgann LPC ...... 165,166 Papotto, Joseph DO ...... 16 Neal, Cynthia APRN ...... 199 Orlando, Erik PT ...... 214 Paragas, Lamberto MD ...... 96 Nelsen, Cara LCSW ...... 187 Ortiz, Veronica MD ...... 122 Parent, Jennifer SLP ...... 224 Newman, Richard MD ...... 28,41,99 Osaguona, Stephen MD ...... 55,58 Parish, Jan SLP ...... 177 Newman, Ted OD ...... 35 Osman, Richard MD ...... 86 Parker, Melinda APRN ...... 172,206 Ng, Daniel MD ...... 121 Osmanzai, Yama MD ...... 94 Parker, Stephen MD ...... 214 Nguyen, Sean MD ...... 16 Osorio, Jolene APRN ...... 170 Parkway Surgery Center LLC .... 141 Nichols, William MD ...... 23 Ovanna Budhram, Joni MD ...... 5 Partridge, Heather LPC ...... 194 Nicol, Philip MD ...... 86,96 Owens, Daniel MD ...... 3 Paschal, Hudnall MD ...... 9 Niederwerfer, Robin APRN ...... 199 Owens, Elijah MD ...... 61 Patchett, Jennifer MD ...... 65 Nirenstein, Michael MD ...... 16 Owens, Kimberly APRN ...... 172 Patel, Kunal DC ...... 47 Nixon, Bevin CSW ...... 187 Oza, Veeral MD ...... 50 Patel, Neil MD ...... 28,41,61 No Bounds Care Inc ...... 135 P Patel, Nirlep MD ...... 96 Nodrick, Deborah MD ...... 38 P & H Pharmacy ...... 232 Patel, Supen MD ...... 55 Norman, Mary CSW ...... 187 Pacheco, Stephanie CRNA ...... 180 Patrick, Sean OD ...... 68 Norris, Sarah CNP ...... 199 Pack, Mark MD ...... 27,52,123 Patterson, Melissa APRN ...... 199 Norton, Julien MD ...... 85 Pacult, Arthur MD ...... 101 Patterson, Yolanda LPC .....228,229 Norton, Laura PHD ...... 112,145 Padgett, Edwin MD ...... 31,49 Patton, John MD ...... 30,46 Novinger, Travis MD ...... 1 Pageland Dialysis ...... 134 Patton, Melissa PT ...... 214 Novis, Sarah MD ...... 85 Pageland Family Pharmacy ...... 232 Paudel, Vijay MD ...... 98 Null, Elizabeth MD ...... 28,41,99 Painter, Autumn APRN 183,205,227 Pavy, Michael MD ...... 53 Nursing Home Dispensary ...... 233 Palmer, Susan SLP ...... 221 Payne, Tricia CSW ...... 183,188

www.wellcare.com/South-Carolina | 271 38642781

Provider Index

P - cont. Powell, Kimberly APRN ...... 155 Regional Health Testing Center Powers, James MD ...... 94,97 LLC ...... 140 Pearson, Andrew MD ...... 88 Prather, Landon PA ...... 219 Regmi, Subash MD ...... 58 Pearson, Joseph MD ...... 52 Praylow, Tiona MD ...... 112 Reid, Carol MD ...... 86 Pecylak, Colleen PT ...... 214 Prenatt, William MD ...... 16 Reid, Maribeth APRN ...... 179,183 Pee Dee Eye Associates ...... 34 Pressley, Veronica LPC ...... 154 Reliable Medical Of Conway LLC Pee Dee Mental Health Center Price, Stacie SLP ...... 221 ...... 144 ...... 135,137,149 Priganc, Tammy PT ...... 215 Remines, Michael DO ...... 20 Pelinka, Sarah APRN ...... 208,209 Prior, David MD ...... 36 Reusche, Christian MD ...... 73 Pellicani, Ronald DC ...... 84 Pritchard, Pamela APRN ...... 169 Reynolds, Brandie MD ...... 9 Pelstring, Mark MD ...... 16 Pritchard-Boone, Andrea PHD ..74 Reynolds, Lauren CRNA ...... 179 Pendergrass, Kimberly SLP ...... 224 Prock, Kelly OT ...... 208 Reynolds, Mark MD ...... 52 Penmetsa, Ram MD ...... 83 Proctor, Charles MD ...... 104 Reynolds, Susan MD ...... 4 Penzo Shumard, Asya LMSW .....32 Professional Pharmacy Of Olanta Rhyne, Jack LCSW ...... 152 Perry, John MD ...... 78,115 ...... 236 Rice, Nicole DO ...... 16 Peterkin, Vicky LCSW ...... 163 Professional Pharmacy Services Rich, David MD ...... 117 Peters, Jon APRN ...... 170 Inc ...... 139 Richey, John MD ...... 52 Peterson, Barbara SLP ...... 224 Professional Pharmacy ...... 233 Richmond, Gayle MD ...... 103 Petkovsek, Alexander APRN .....199 Publix Super Markets ...... 239 Rimkus, Gilbertas MD ...... 91,124 Pharmacy Express LLC ...... 139 Pugh, Kevin MD ...... 71 Rintelman, Michael LPC ...... 166 Phillips, Kristopher PT ...... 214 Purvis, Robert MD ...... 85 Riordan, Katherine MD ...... 41,61 Phillips, Morgan PA ...... 218 Putman, Jesse DO ...... 110 Riverarosado, Emanuel MD ...... 71 Phillips, Stephen MD ...... 104 Putman, Stephen MD ...... 110 Rivertown Pharmacy Inc ...... 239 Piacentino, Valentino MD ...... 91 Rivertown Surgery Center ...... 141 Piccolo, Carmen DO ...... 79,120 Q Rives, Thomas MD ...... 19 Pickett, Michael LPC ...... 194 Quaye, Emmanuel MD ...... 11,32 Roberson, Caroljane MD ...... 112 Piggly Wiggly Pharmacy ...... 236 Quaye, Michelle MD ...... 33 Roberts, Brian MD ...... 117,118 Pinnola, Aaron DO ...... 91 Quest Diagnostics ...... 133,146 Roberts, Juliet OT ...... 208 Pitiranggon, Pongstorn MD ...55,58 Quick, Sandra ARNP ...... 229 Roberts, Kimberly LPC ...... 177 Pittard, John MD ...... 58 Quillen, Timothy MD ...... 117 Robinette, Lester CSW ...... 188 Pittard, Michelle PA ...... 175 Quinn, Elizabeth SLP ...... 157 Robinson, Allyson LCSW ...... 158 Plancher, Joao Mc-Oneil MD .41,61 R Robinson, Christopher PA ...181,218 Player, Keith MD ...... 52 Rabon, Brian MD ...... 23 Robinson, Joshua MD ...... 66 Plowman, Lesley APRN ...... 205 Rabon, Larry MD ...... 79 Robinson, Leroy MD ...... 33 Po, Christopher MD ...... 98 Rahman, Ossama MD ...... 46 Robinson, Tricia APRN ...... 169 Poland, Emily DO ...... 88,96,97 Ralley, Tasha APRN ...... 171 Rockwell, Mason PT ...... 215 Polsky, Roger APRN ...... 168 Ramirez, Yvonne MD ...... 6 Rogers, Cheryl SLP ...... 221 Poole, R Gary OD ...... 107 Rao, Sreenivas MD ...... 53 Rogers, Katelyn APRN ...... 169 Poole, Trevor MD ...... 91 Raynor, Kathleen MD ...... 88,97 Rogers, Lindsey ARNP ...... 199,200 Porada, Theodore PT ...... 214 Razick, Manver MD ...... 50 Rogers, Mary LPC ...... 166 Positive Influences Inc ...... 137 Reames, Danielle SLP ...... 157 Rogers, Susan SLP ...... 224 Post, Moira CRNA ...... 180 Redfearn, Teresa LPC ...... 154 Rogus, Bernard MD ...... 79 Poston, Jerd OD ...... 107 Refvem, William MD ...... 71 Rollings, Jan LCSW ...... 183,184,188 Poston, Laurie PT ...... 174 Roman, John LCSW ...... 189 Powell, Joseph MD ...... 3

www.wellcare.com/South-Carolina | 272 38642781

Provider Index

R - cont. Scharstein, Jeffrey MD ...... 3 Simon-Mcqueen, Ryedenna Schilsky, Suezen DC ...... 38 LMHC ...... 166 Roode, Richard PA ...... 218 Schimnowski, Amanda MD ...... 17 Simpson, Jada ARNP ...... 155 Ropp, John MD ...... 3 Schindler, Joycelyn MD ... 28,43,103 Sims, David MD ...... 77 Rosi, David DO ...... 47 Schneider, Nicole PT ...... 215 Sims, Whitney PA ...... 175 Rosner, Daniel MD ...... 86 Schultz, Agnes MD ...... 1 Singh, Githa PT ...... 215 Ross, Mark MD ...... 66 Schultz-Peters, Sandra APRN ..205 Singh, Harmohan MD ...... 55 Ross, Scott MD ...... 16 Sciarretta, Jason MD ...... 92 Singh, Inderpal MD ...... 58,124 Rotech ...... 145 Scott, Brian MD ...... 88 Singh, Navdeep MD ...... 49 Rowe, Llewellyn MD ...... 56 Scott, Vincent MD ...... 65 Single, Daniel MD ...... 110 Rowson, Abraham MD ...... 9 Scruggs, Miles OD ...... 35 Sizemore, Patrick MD ...... 32 Rozario, Catherine MD ...... 16 Sealey, Darren DC ...... 121 Skinner, Motte MD ...... 31,49 Ruggerio, Joseph APRN ...... 205 Seashore Drugs ...... 239 Skinner, Roland MD ...... 62 Runyan, Chadley MD ...... 77 Sebesto, Jason DO ...... 41,62 Skinner, Wright MD ...... 125 Ruonala Durable Medical Sedwick, Carly PA ...... 218 Skipper, Stephen DC ...... 30 Equipment ...... 145 Seif, Fadi MD ...... 75 Skvarka, Christopher MD ...... 85 Rush, Amy LPC ...... 166 Seitzinger, Veronica CSW ..189,219 Slice, Allison CNP ...... 171 Rush, Paul MD ...... 123 Sellers, Donna APRN ...... 159 Sloan, Charlotte APRN ...... 200 Russ, Brandi ARNP ...... 169 Seltzer, Samuel MD .... 33,43,66,104 Sloan, Theresa LPC ...... 219 Russell, Samuel OD ...... 68 Senseney, Anna MD ...... 4,76 Smalls, Chatonia CSW ...... 163 Ryan, Patrick DO ...... 16 Serafin, Jeremy LPC ...... 154 Smid, John MD ...... 123 Rzucidlo, Eva MD ...... 29,79,120 Sevilis, Theresa DO ...... 42,62 Smith III, Charlie MD ...... 78,125 S Shadiack, Anthony DO ...... 17 Smith, Allan CRNA ...... 161 Saha, Sam MD ...... 41,61 Shah, Vipul MD ...... 55 Smith, Amy APRN ...... 200 Salama, George MD ...... 79 Shakeel, Muhammad MD ...... 122 Smith, Cory MD ...... 9,31,49 Samaha, Anne MD ...... 9 Sharma, Snigdha MD ...... 113 Smith, Franklin OD ...... 107 Sams Club Pharmacy ...... 236,239 Shaver, Robin PA ...... 218 Smith, James MD ...... 53,57,101 Sanders, Alexis PHD ...... 74 Shea, Kevin MD ...... 94 Smith, Justin CNP ...... 206 Sanders, Lecole LCSW ...... 162 Shealy, Robin MD ...... 6 Smith, Lisa PA ...... 176 Sanders, Melanie MD ...... 17 Shelton, Heather MD ...... 9 Smith, Machelle APRN ...... 171 Sandhills Med Foundation ...... 134 Shenouda, Hany MD ...... 48 Smith, Morgan APRN ...... 171 Sandhills Medical Pharmacy .....232 Sherrill, Phillip PT ...... 215 Smith, Robert CSW ...... 228 Sandoz, George MD ...... 99,100,104 Sherrys Meds And More Smith, Sherry PT ...... 229 Sansbury, Jilian MD ...... 20,21 Pharmacy ...... 239 Smith, Tara APRN ...... 205 Santana Alarcon, Lhissa MD ...... 123 Sherwin, David MD ...... 3 Smith, Tara NP ...... 21 Santiago, Kenneth MD ...... 97 Sheth, Rasesh PA ...... 196 Smock, Alison MD ...... 58 Sasser, Paul MD ...... 91,92 Shissias, Charles MD ...62,74,100,112 Snapp, Isaac PA ...... 157,175 Saxon, Angela APRN ...... 158,171 Shore, Neal MD ...... 118 Snyder, Michael MD ...... 42,62 Saylor, Scott CRNA ...... 161 Shumate, Melissa PT ...... 156 Soles, Margaret SLP ...... 224 Sc Department Of Juvenile Justice Sibille, Joshua MD ...... 92 Solheim, Vesna MD ...... 86 ...... 134,135,136,137,141,149,150 Siegmund, Kelle OD ...... 68,107 Solstas Quest Diagnostics ...... 147 Scearce, Edward PSYD ...... 75 Silbiger, Stephen MD ...... 21 Sombutmai, Chut DO ...... 42,62 Schaefer, Catherine MD ...... 17 Simon Mcqueen, Ryedenna LPC Sonfield, John MD ...... 52 Schank, Stephanie SLP ...... 224 ...... 177 Sood, Aditya MD ...... 83

www.wellcare.com/South-Carolina | 273 38642781

Provider Index

S - cont. Stoughton, Thomas MD ...... 46 The Mobility Center Of The Stranckmeyer, Shawn MD ...... 87 Grand Strand ...... 145 Soucy, Madeline APRN ...... 206 Strand Gastrointestinal The Pharmacy At Cmc ...... 239 South Carolina Youth Advocate Endoscopy Center ...... 141 The Pharmacy ...... 236 Program ...... 141 Strauss, Louis MD ...... 49 Thomas, Brady CRNA ...... 161 Sparkman, Jeremy DO ...... 71 Strickland, Gwendolyn PA ...... 227 Thomas, Chadwick MD ...... 27,121 Spence, Thomas MD ...... 12 Strickland, Laura PA ...... 176 Thomas, Jude MD ...... 1 Spence, Timothy MD ...... 12 Strickland, Stephanie MD ...... 10 Thomas, Julie PA ...... 176 Spencer, Olinda MD ...... 100 Stuart, Robert MD ...... 101,145 Thomas, Shawn OD ...... 107 Spencer, Thomas MD ...... 76 Stuckey Pharmacy ...... 243 Thompkins, Kathy APRN ...... 227 Sperling, Michael MD ...... 21 Stuckey, Dominica LPC ...... 229 Thompson, Angel APRN ...... 156 Sponseller, Brian MD ...... 3 Stull, Ashley OT ...... 208 Thompson, Donna LCSW .. 184,189 Sponseller, Kevin MD ...... 3 Stutler, Tammy LPC ...... 194 Thompson, Kenneth DO ...... 22 Sproul, Jack MD ...... 36 Subnani, Kishore MD ...... 55,97 Thumallapally, Nishitha MD ...... 93 Spurling, Timothy MD ...... 50 Suffrant, Germina MD ...... 65 Thurman, Chad DO ...... 71 Srivastava, Abhishek MD ...... 118 Sullivan, Nekita PT ...... 215 Thurman, Sarah MD ...... 113 Stahl, Russell MD ...... 115 Sullivan, Scott MD ...... 57 Tidelands Health Imaging ...142,143 Stanley, Christopher MD ...... 10,17 Surratt, Susan ARNP ...... 181 Tigist, Mehari MD ...... 42 Stanley, Regina APRN ...... 206 Sutton, Darin MD ...... 86 Timmons, Lindsey APRN ...... 171 Staples, Karen APRN ...... 200 Sutton, Michael DO ...... 44 Timmonsville Pharmacy ...... 236 States, Lindsey APRN ...... 206 Sved, Amy APRN ...... 162 Todd, Molly PT ...... 215 Steadman, Mark MD ...... 10 Swift, Catherine MD ...... 97 Tohid, Usman PA ...... 157,176 Steele, Patrick CP ...... 75 Tollison, Steven MD ...... 65,124 Steichen, John MD ...... 101,145 T Tolmos, Jorge MD ...... 27 Steljes, Megan APRN ...... 206 Tagliareni, Jonathan DDS ...... 69 Toman, Jordan MD ...... 146 Stellingworth, Mark MD ...... 30 Takara, James MD ...... 115 Tonkin, David MD ...... 110 Stephen, Natasha CNP ...... 169 Talbert, Wendy LPC ...... 220 Toole, John MD ...... 83 Stephenson, Jennifer SLP ...... 222 Tanner, Scott CRNA ...... 161 Torgersen, Keith CRNA ...... 158,161 Stevens, Holly SLP ...... 178 Tardy, Paul OT ...... 208 Torosian, Valeriya OT ...... 208 Stevens, Jimmy PA ...... 218 Tatum, Charles MD ...... 65 Touloukian, Emily DO ...... 93 Stevenson, Robert PA ...... 175 Taylor, Laura MD ...... 145,146 Townsend, Anna LPC ...... 166 Stewart, Caren LPC ...... 194 Taylor, Ross MD ...... 110 Trader, Andrea CNP ...... 155 Stewart, Danielle SLP ...... 222 Taype Perez De Roberts, Carmen Trant, Charles MD ...... 72 Stewart, Martha LPC ...... 166 MD ...... 55 Trevino, Amanda ARNP ...... 200 Sto Domingo, Judie PT ...... 229 Tazi, Karim MD ...... 53 Tri County Mental Health ...... 150 Stoker, James PT ...... 215 Teague, Allen LPC ...... 184,194 Trinh, Vinh DO ...... 21 Stokes, Ernest PA ...... 225 Teague, Daloria LCSW ...... 158 Trinity Behavioral Care ...... 136 Stokes, Hunter MD ...... 66,67 Tedder, Tona APRN ...... 155 Troutman, Ina PA ...... 219 Stokes, Mark MD ...... 66,67 Temple, Megan LPC ...... 166 Troutman, Lucia PA ...... 219 Stone, Amanda DC ...... 47 Terchek, Melissa MD ...... 97 Truesdale, Lakisha SLP ...... 222 Stone, Harry MD ...... 30,45 Thasitis, Jessica ARNP ...... 200 Truluck, David MD ...... 83 Stone, Kaitlin APRN ...... 181 The Alpha Behavioral Health Tucker Wells Medical Inc ...... 139 Stonerock, Charles MD ...... 80 Center ...... 134 Tumbleson, Catherine PA ...... 219 Stonerock, Emily MD ...... 65 The Medicine Cabinet ...... 236 Tunstall, Marsha LPC ...... 177 Stoney, Gertrude CSW ...... 227 The Medicine Shoppe ...... 239

www.wellcare.com/South-Carolina | 274 38642781

Provider Index

T - cont. Vinson, Tiffany MD ...... 18 Well Center Pharmacy ...... 236 Vistara Pharmacy ...... 236 Wells, Terrance LPC ...... 167,231 Turbeville, Lisa OD ...... 107 Vukov, Gary MD ...... 88 Wenner, Bryan DC ...... 47 Turek, James MD ...... 19 West, Jesse PHD ...... 32 Turner III, Robert MD ...... 76 W West, Timothy MD ...... 94 Turner, Allison PT ...... 215 Waccamaw Center For Mental Wheeler, Betty SLP ...... 224 Turner, Amy PA ...... 219 Health ...... 141,151 White, Amie Kaye PT ...... 216 Turner, Robert MD ...... 76 Waccamaw Crs ...... 141 White, Cameron SLP ...... 222 Twaddle, Carianna PT ...... 215,216 Wakefield, Hannah MD ...... 111 White, Kristin SLP ...... 177 Twining, Jon MD ...... 114 Walgreens Drug Store ...... 239 White, Nicholas MD ...... 52 Tyner, Christopher CRNA ...... 161 Walker, James SLP ...... 222 White, Steven MD ...... 111 Tyner, Faith LPC ...... 166,167 Walker, Juliette MD ...... 23 Whitehead, Alva MD ...... 12 Tyree, Christopher DPM ...... 73 Wall Drugs Of Johnsonville Inc Whitehurst, Emily APRN ...... 206 Tyson, Deidre MD ...... 72 ...... 236 Whiteside, Daniela MD ...... 67 Wall Drugs Of Pamplico Inc .... 236 U Whiteside, William MD ...... 110 Wallace, Christy OD ...... 69 Whitley, Allie DO ...... 18 Ulmer, John PA ...... 173 Wallace, Donya LPC ...... 167,231 Whitman, Gretchen LPC .....167,195 Underwood, Timothy LPC .167,194 Wallace, James MD ...... 6 Wicker, Maryum APRN ...... 155,169 Unger, Patricia LPC ...... 194 Wallace, Lisa APRN ...... 171 Wicker, Sonia PA ...... 176 V Wallace, Panora LPC ...... 152,155 Wiggins, Christi APRN ...... 171 Wallace, Robert OD ...... 69 Vajapey, Geetanjali MD ...... 42,62 Wightman, Haley SLP ...... 178 Valanta, Douglas MD ...... 42,62 Walmart Pharmacy ...... 232,233,234,236,240,241,242 Wilcox, Scott LPC ...... 167 Valrie, Teah SLP ...... 222 Wilfong, Charles OD ...... 69 Vance, Darren PT ...... 216 Walmart Vision Center ...... 34,67,104,105 Wilkins, Francesca MD ...... 48 Vance, Stephen MD ...... 6 Wilkinson, Laura LPC ...... 195 Vandergriff, Joseph MD ...... 17 Walsh, Christopher MD ...... 110 Walter, Kevin DC ...... 84 Wilkoszewski, Artur MD ...... 18 Vanderhave, Kelly MD ...... 71 Williams, Leslie LPC ...... 178 Vanhoogen, Ut Uyen LPC ...... 220 Walter, Lauren SLP ...... 224 Wangeh, Joseph MD ...... 6 Williams, Misty LPC ...... 167 Varney, Michael MD ...... 21 Williams, Ricki SLP ...... 224 Vasuki, Nagavivek MD 33,44,67,104 Wannamaker Drug ...... 232 Wannamakers Drug Store ...... 232 Williams, Ryan DO ...... 10 Vaught, Heather OD ...... 108 Williams, Ryan OD ...... 108 Vaught, James Dylan OD ...... 107 Ward, Mary LPC ...... 184,185,195 Warren, Michelle SLP ...... 222 Williams, Taylor OT ...... 208 Vaught, James OD ...... 107 Williams, Tisha MD ...... 18 Vaught, Winston MD ...... 37 Washington, Dode MD ...... 103 Washington, Tonya MD ...... 3 Williamsburg County Department Vega, Jose MD ...... 42,100 On Alchol ...... 151 Vemuri, Praveen MD ...... 100 Waterway Pharmacy ...... 240 Watson, Heber DO ...... 18 Williamsburg County Health Ventura, Katherine PA ...... 185 Department ...... 151 Watson, Jerry MD ...... 83 Vermillion, Krystal OT ...... 208 Williamsburg Pharmacy ...... 243 Watt, Nigel MD ...... 71 Vest, James MD ...... 17,18 Williamsburg Regional Hospital Weaver, Timothy APRN ...... 171 Vidgop, Yelana MD ...... 42,62,100 ...... 132 Wegmann, Jessica PA ...... 160 Villane, Kaycee PA ...... 219 Williamson, Heather LCSW ...... 160 Weiner, Edward OD ...... 108 Villeneuve, Emery CRNA ...... 161 Wilson, Addison MD ...... 71 Weingart, Kristin SLP ...... 222 Vincent, Heather PA ...... 181 Wilson, Beverly APRN ...... 181,185 Welch, Erin PT ...... 216 Vinson, Mark OD ...... 122 Wilson, Ryan APRN ...... 200 Welch, Priscilla MD ...... 3

www.wellcare.com/South-Carolina | 275 38642781

Provider Index

W - cont. Zeplin, Vincent OD ...... 35,69,108 Zito, Caroline SLP ...... 225 Wilson, Tanya SLP ...... 222 Wilson, Toni Marie CSW ...... 163 Wiltshire, Charlotte RD ..... 185,206 Wineland, Rebecca MD ...... 65 Winkler, Gabor MD ...... 80,120 Wise, Garett OD ...... 108 Witkowski, Mark DO ...... 92 Wolery, James MD ...... 56 Wolford, John MD ...... 50 Won, Mai MD ...... 42,62 Wood, Joseph MD ...... 119 Woodberry, Elizabeth APRN ...169 Woodberry, William MD ...... 122 Woodbury, David MD ...... 71,77 Woodward, Tracie APRN ...... 156 Wooten, Charles MD ...... 76 Worthington, Ward MD ...... 100,145 Wotherspoon, Barbara MD ...... 103 Wright, Carol LSW ...... 167 Wright, David MD ...... 125 Wright, Lisa MD ...... 18,145 Wynkoop, Aaron MD ...... 36 Wyont, Shannon PT ...... 174 X Xiong, Chue MD ...... 18 Y Yarnal, James DO ...... 56 Young, Desmond MD ...... 113 Young, Dierdre MD ...... 11 Young, Eric MD ...... 52,92 Young, Matthew MD ...... 119 Young, Richard MD ...... 110,119 Young-Cline, Nicole SLP ...... 224 Z Zaenger, David MD ...... 113,114 Zakhour, Isam MD ...... 67 Zaman, Mohammed DO ...... 42,62 Zaraket, Vera MD ...... 50 Zebian, Rami MD ...... 75 Zein, Mohamad MD ...... 76 Zeleke, Akal MD ...... 49

www.wellcare.com/South-Carolina | 276 38642781

Notice of Non-Discrimination WellCare of South Carolina follows all federal civil rights laws. We do not exclude or treat people in a different way based on race, color, national origin, age, disability or sex. WellCare of South Carolina provides free aids and services to people with disabilities. We have sign language interpreters. We can give you our materials in other formats such as large print, braille, and audio. We also offer free language services if English is not your first language. That includes qualified interpreters and information written in other languages. If you need these services, contact Member Services toll-free at: 1-888-588-9842 (TTY 711). You can write to us at: P.O. Box 31370, Tampa, FL 33631-3370. You can also reach us online at: www.wellcare.com/South-Carolina. Click on the Members drop-down menu. Then, click Contact Us. You can send us a secured message. Do you think that WellCare of South Carolina has not given you the services you deserve? Do you think that they have discriminated in some way based on race, color, national origin, age, disability or sex? If so, you can file a grievance with us using the contact information listed above. You can file a grievance in person or by phone or by mail. If you need help filing a grievance, we can help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. You can file through the Office for Civil Rights Complaint Portal at https://ocrportal.hhs.gov/ocr/ portal/lobby.jsf. Or you can file by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue, SW, Room 509F, HHH Building, Washington, D.C. 20201. You can also reach them by phone at: 800-368-1019, (TDD 800-537-7697). You can find complaint forms at http://www.hhs.gov/ocr/office/ file/index.html. Language Services If English is not your first language, we can translate for you. We can also give you the information in other formats such as Braille, audio and large print. These services are free of charge. Just give us a call toll-free at 1-888-588-9842 (TTY 711). Si el español mexicano es su lengua materna, podemos brindarle servicios de traducción. También podemos proporcionarle la información en otros formatos, como braille, audio y letra de imprenta grande. Estos servicios se ofrecen sin cargo. Simplemente llámenos sin cargo al 1-888-588-9842 (TTY 711).

إذا كانت لغتك ا صلية هي اللغة العربية، فنحن بأستطاعنا ال جمة لك. و كننا أيضاً إعطائكم ا علومات اشكال اخرى مثل طريقة ال ايل للمكفوف والصوت وا طبوعات ذات الحجم الكب . هذه الخدمات تقدم مجاناً وبدون مقابل. فقط قم با تصال ع رقم التلفون ا جا : 9842-588-888-1 أو (TTY 711).

CAD_21077E State Approved 11042016 ©WellCare 2018 SC8CADINS21077E_1800 38642781

Se o Português for a sua língua materna, nós podemos traduzir para si. Também lhe podemos fornecer as informações noutros formatos, tais como Braille, áudio e impressão grande. Estes serviços são gratuitos. Entre em contacto connosco através da linha de atendimento gratuita 1-888-588-9842 (TTY 711). Если русский Ваш основной родной язык, мы можем перевести для Вас. Мы также можем предоставить информацию в других форматах, например, на шрифте Брайля, записанную на аудионосителях и распечатанную крупным шрифтом. Данные услуги предоставляются бесплатно. Просто позвоните нам по бесплатному номеру 1-888-588-9842 (TTY 711). Nếu Tiếng Việt là ngôn ngữ chính của quý vị, chúng tôi có thể thông dịch cho quý vị. Chúng tôi cũng có thể cung cấp cho quý vị thông tin ở các định dạng khác như chữ nổi Braille, âm thanh và bản in cỡ lớn. Các dịch vụ này miễn phí. Chỉ cần gọi chúng tôi theo số miễn phí 1-888-588-9842 (TTY 711). Se a sua língua materna é o português brasileiro, nós podemos traduzir para você. Podemos também fornecer-lhe as informações em outros formatos, tais como Braille, áudio e impressão grande. Estes serviços são gratuitos. Entre em contato conosco através da linha de atendimento gratuita 1-888-588-9842 (TTY 711). 如果中文是您的母語，我們可以為您翻譯。我們也可以用其它格式 為您提供資訊，如布萊葉文、音頻及大字體。這些皆為免費服務。 僅需撥打免費電話 1-888-588-9842 (TTY 711) 聯絡我們。 Falam tongih tongmi na si ahcun na tong kan lo letsak thei. Thu theihterawknak ah a phunphun - mitcaw hrang siar theih dingih an ngannak ca, awsuak ih ngai theih ding in le cafang tum zetzet ih tuahmi ca tivek khal kan lo pe thei. Cuvek ih thu theihterawnak cu man pek tul loin an um. 1-888-588-9842 (TTY 711) ah paisa cem tul lo in ko mai ding a si. 38642781

अगर आपकी मात ृ भाषा हिंदी िै तो िम आप के लिए अनुवाद कर सकते ि । िम आपको ेि, ऑहियो और बडे प ंट जैसे अनय प म भी जानकारी दे सकते ि । ये सेवाएं पबना शुलक ि । बस िम इस टोि ी नंबर पर कॉि कर 1-888-588-9842 (TTY 711). 귀하의 모국어가 한국어 인 경우, 통역서비스를 제공해 드립니다. 점자, 오디오, 큰 활자 등 다른 형식으로 된 정보도 제공해 드릴 수 있습니다. 이 서비스들은 무료입니다. 무료 전화 1-888-588-9842 (TTY 711)번으로 전화 주십시오. Hakha Chin holh kha na hmangmi holh a si ahcun nangmah caah kan in leh piak khawh. Phun dang deuh in tuaktaan piaknak a simi mitcaw pawl rel khawhmi hmelchunhnak, aw le ca nganpi in chuah piaknak ti bantukin thawngthanhnak pek khawh na si thiamthiam. Hi tuah piakmi pawl hi a lak tein a si. Hika hin auh khawh kan si 1-888-588-9842 (TTY 711). Si votre langue maternelle est le français, nous pouvons faire la traduction. Nous pouvons également vous fournir l’information dans des formats comme le braille, en version audio et imprimé en gros caractères. Ces services sont offerts gratuitement. Il suffit de nous appeler au numéro sans frais 1-888-588-9842 (TTY 711). u nD usdm rh rh> e *H> cD. xH; usdm tDR vX e *D> oh M. vDRIAy [h. eR w> *h>w > usdR vX usJ uh> y eD. t *R w z.’f trh>AySR rJm w xH. w> t vHm u vk> pJ usH; z; ‘d. oh ph> uD; M. vDRIAw> zH; w> rR w z. tHR w vXm bl; vJ b. M. vDRIAxJ ‘. ud; vD wJ pd vX w vXm ph ql y td. zA1-888-588-9842 (TTY 711)AM. vDRI አማርኛ የመጀመሪያ ቋንቋዎ ከሆነ፣ ልናስተረጉምልዎ እንችላለን። በተጨማሪም መረጃዎቹን በሌሎች የአቀራረብ መንገዶች ለምሳሌ፣ በብሬል፣ በድምጽ ቅጂ እና በትልልቅ ህትመቶች መልክ ልንሰጥዎ እንችላለን። እነዚህ አገልገሎቶች ከክፍያ ነጻ ናቸው። በነጻ የስልክ መስመር 1-888-588-9842 ላይ (TTY 711) ላይ ይደውሉልን። သင့္၏မိခင္ဘာသာစကားက ျမန္မာဘာသာျဖစ္သည္ဆိုလွ်င ္ ကြ်ႏု္ပ္တို႔ဘက္က သင့္အတြက္ဘာသာျပန္ေပးနိုင္ပါသည္။ အခ်က္အလက္မ်ားက ို မ်က္မျမင္စာ၊ အသံဖိုင္၊ႏွင့္ပံုႏွိပ္စာတို႔လို အျခားပံုစံမ်ားျဖင့္ သင့္ထံေပးထားနိုင္ပါသည္။ ထိုဝန္ေဆာင္မႈမ်ားသည ္ အခမဲ့ျဖစ္ပါသည္။ 1-888-588-9842 (TTY 711). မွတဆင ့္ ကြ်ႏု္ပ္တို႔ထ ံ အေဝးေျပာခမကုန္ဘ ဲ ေခၚဆိုနိုင္ပါသည္။ 38642781 38642781

1-888-588-9842 (TTY 711)

www.wellcare.com/South-Carolina