| |
1656 Riverchase Blvd Ste 2400 Rock Hill SC 29732-2084 | |
(803) 329-5131 | |
Not Available |
Full Name | |
---|---|
Speciality | Internal Medicine |
Location | 1656 Riverchase Blvd, Rock Hill, South Carolina |
Authorized Official Name and Position | Scott Rissmiller (ENTERPRISE EVP) |
Authorized Official Contact | 7046310002 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 19305 Charlotte NC 28219-9305 Ph: (704) 631-0002 | 1656 Riverchase Blvd Ste 2400 Rock Hill SC 29732-2084 Ph: (803) 329-5131 |
NPI Number | 1013675669 |
---|---|
Provider Enumeration Date | 12/01/2021 |
Last Update Date | 11/22/2024 |
Medicare PECOS PAC ID | 3375449655 |
---|---|
Medicare Enrollment ID | O20220408002145 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013675669 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Community Medicine Foundation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Piedmont St, Rock Hill, SC 29730 Phone: 803-325-7744 | |