Premier Cardiovascular Care | |
1040 Edgewater Corporate Pkwy Fort Mill SC 29707-4514 | |
(704) 609-7334 | |
(855) 655-3374 |
Full Name | Premier Cardiovascular Care |
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Speciality | Clinic/Center |
Location | 1040 Edgewater Corporate Pkwy, Fort Mill, South Carolina |
Authorized Official Name and Position | David N Smith (OWNER) |
Authorized Official Contact | 7046356071 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Premier Cardiovascular Care 1600 Churchill Downs Dr Waxhaw NC 28173-6627 Ph: (704) 609-7334 | Premier Cardiovascular Care 1040 Edgewater Corporate Pkwy Fort Mill SC 29707-4514 Ph: (704) 609-7334 |
NPI Number | 1245625813 |
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Provider Enumeration Date | 04/01/2015 |
Last Update Date | 10/26/2021 |
Certification Date | 10/26/2021 |
Medicare PECOS PAC ID | 0749591410 |
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Medicare Enrollment ID | O20150622001843 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245625813 | NPI | - | NPPES |
Provider Name | David Nathaniel Smith |
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Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1780780031 PECOS PAC ID: 9830276476 Enrollment ID: I20090406000634 |
Provider Name | Willie E Hester |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1730354002 PECOS PAC ID: 9335115054 Enrollment ID: I20090721000737 |
Provider Name | Tremika R Woodley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699217208 PECOS PAC ID: 6507141876 Enrollment ID: I20170329000703 |
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