| Cmp Senior Healthcare Llc | |
|
1040 Edgewater Corporate Pkwy Ste 104 Fort Mill SC 29707-4526 | |
| (803) 547-8660 | |
| (803) 650-3880 |
| Full Name | Cmp Senior Healthcare Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1040 Edgewater Corporate Pkwy Ste 104, Fort Mill, South Carolina |
| Authorized Official Name and Position | Nimish Patel (OWNER) |
| Authorized Official Contact | 8035478660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cmp Senior Healthcare Llc 10535 Flennigan Way Charlotte NC 28277-1417 Ph: () - | Cmp Senior Healthcare Llc 1040 Edgewater Corporate Pkwy Ste 104 Fort Mill SC 29707-4526 Ph: (803) 547-8660 |
| NPI Number | 1891420857 |
|---|---|
| Provider Enumeration Date | 07/22/2022 |
| Last Update Date | 07/22/2022 |
| Medicare PECOS PAC ID | 4183091242 |
|---|---|
| Medicare Enrollment ID | O20221102000340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891420857 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Nimish Kantilal Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710141668 PECOS PAC ID: 2163566357 Enrollment ID: I20100225000947 |
| Provider Name | Shephali Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538386610 PECOS PAC ID: 4587690797 Enrollment ID: I20100611000216 |
| Provider Name | Megan Blackwelder Keener |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316607583 PECOS PAC ID: 4183003395 Enrollment ID: I20220617002256 |
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