| Dr. For Life, Llc | |
|
1202 E Butler Rd Greenville SC 29607-5910 | |
| (864) 640-0009 | |
| (864) 558-0589 |
| Full Name | Dr. For Life, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1202 E Butler Rd, Greenville, South Carolina |
| Authorized Official Name and Position | Judith Richter (MANAGER ASSISTANT) |
| Authorized Official Contact | 8642027033 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. For Life, Llc 2131 Woodruff Road Suite 2100 #127 Greenville SC 29607-5959 Ph: (864) 640-0009 | Dr. For Life, Llc 1202 E Butler Rd Greenville SC 29607-5910 Ph: (864) 640-0009 |
| NPI Number | 1881028892 |
|---|---|
| Provider Enumeration Date | 08/27/2013 |
| Last Update Date | 02/24/2015 |
| Medicare PECOS PAC ID | 2264668540 |
|---|---|
| Medicare Enrollment ID | O20131114000858 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881028892 | NPI | - | NPPES |
| GP6250 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ma Cheryl A Sarmiento |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639102288 PECOS PAC ID: 4385642891 Enrollment ID: I20061116000544 |
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