| Carolina Healthchoice Of Greenville, Llc | |
|
274 Commonwealth Dr Ste B Greenville SC 29615-4872 | |
| (864) 478-8580 | |
| (864) 478-8520 |
| Full Name | Carolina Healthchoice Of Greenville, Llc |
|---|---|
| Speciality | Pain Medicine |
| Location | 274 Commonwealth Dr Ste B, Greenville, South Carolina |
| Authorized Official Name and Position | Amber Compton (PRACTICE MANAGER) |
| Authorized Official Contact | 8037640464 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Healthchoice Of Greenville, Llc 1494 Lake Murray Blvd Fl 2 Columbia SC 29212-8697 Ph: (803) 764-0464 | Carolina Healthchoice Of Greenville, Llc 274 Commonwealth Dr Ste B Greenville SC 29615-4872 Ph: (864) 478-8580 |
| NPI Number | 1245744937 |
|---|---|
| Provider Enumeration Date | 11/17/2017 |
| Last Update Date | 12/19/2018 |
| Medicare PECOS PAC ID | 9032471032 |
|---|---|
| Medicare Enrollment ID | O20180402000558 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245744937 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | (* (Not Available)) | Primary |
| Provider Name | Lorone Cowayne Washington |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174628077 PECOS PAC ID: 8921047515 Enrollment ID: I20050906000318 |
| Provider Name | Jennifer M Paglia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356530497 PECOS PAC ID: 6103915921 Enrollment ID: I20071203000020 |
| Provider Name | Regina Rouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487938825 PECOS PAC ID: 0042484974 Enrollment ID: I20111110000762 |
| Provider Name | Evans Nestertsov |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689390759 PECOS PAC ID: 5890162390 Enrollment ID: I20221111001017 |
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