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Northlake Family Medical Practice

Debarred entity

Northlake Family Medical Practice is an entity of interest. It has not been found on international sanctions lists.

Type	Legal entity				[sources]
Name	Northlake Family Medical Practice				[sources]
Legal form	not available				[sources]
Country	United States				[sources]
NPI	`1003928680`				[sources]
Sector	Physician Group - Family Practice				[sources]
Status	not available				[sources]
Address	Columbia, SC 29223				[sources]
Last change	2025-07-25	Last processed	2025-10-15	First seen	2025-07-25

Sanctions
Country	Authority	Program	Start date	End date
United States	South Carolina Department of Health and Human Services		2016-08-22	-

Medical providers excluded from South Carolina's Medicaid program.

United States of America · SCDHHS

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