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1656 Riverchase Blvd Ste 1800 Rock Hill SC 29732-2084 | |
(803) 909-1850 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 1656 Riverchase Blvd, Rock Hill, South Carolina |
Authorized Official Name and Position | Scott Rissmiller (ENTERPRISE EVP) |
Authorized Official Contact | 7043558675 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 19305 Charlotte NC 28219-9305 Ph: (704) 631-0002 | 1656 Riverchase Blvd Ste 1800 Rock Hill SC 29732-2084 Ph: (803) 909-1850 |
NPI Number | 1003288093 |
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Provider Enumeration Date | 10/29/2015 |
Last Update Date | 03/09/2023 |
Medicare PECOS PAC ID | 3375449655 |
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Medicare Enrollment ID | O20170410001830 |
Identifier | Type | State | Issuer |
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1003288093 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
Community Medicine Foundation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Piedmont St, Rock Hill, SC 29730 Phone: 803-325-7744 | |