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221 S Pendleton St Easley SC 29640-3047 | |
(864) 442-5769 | |
Not Available |
Full Name | |
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Speciality | General Practice |
Location | 221 S Pendleton St, Easley, South Carolina |
Authorized Official Name and Position | Andrew Herman (OWNER) |
Authorized Official Contact | 8644425769 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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221 S Pendleton St Easley SC 29640-3047 Ph: (864) 442-5769 | 221 S Pendleton St Easley SC 29640-3047 Ph: (864) 442-5769 |
NPI Number | 1508555764 |
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Provider Enumeration Date | 05/03/2023 |
Last Update Date | 05/02/2024 |
Medicare PECOS PAC ID | 8628417805 |
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Medicare Enrollment ID | O20240421000115 |
Identifier | Type | State | Issuer |
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1508555764 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Andrew Dean Herman |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1598198194 PECOS PAC ID: 2860716677 Enrollment ID: I20150128000116 |
Provider Name | Heather Leslie Bannister |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821528258 PECOS PAC ID: 1254601909 Enrollment ID: I20170727004143 |
Fleetwood Internal Medicine Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 109b Fleetwood Dr, Easley, SC 29640 Phone: 864-855-1036 Fax: 864-855-3318 | |