Ketamine Solutions, Llc | |
138 Milestone Way Ste A Greenville SC 29615-6618 | |
(864) 236-1630 | |
Not Available |
Full Name | Ketamine Solutions, Llc |
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Speciality | Clinic/Center |
Location | 138 Milestone Way Ste A, Greenville, South Carolina |
Authorized Official Name and Position | Joy Bailley (MEMBER) |
Authorized Official Contact | 8645271250 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ketamine Solutions, Llc 3523 Pelham Rd Ste C Greenville SC 29615-4191 Ph: (864) 527-1250 | Ketamine Solutions, Llc 138 Milestone Way Ste A Greenville SC 29615-6618 Ph: (864) 236-1630 |
NPI Number | 1952147498 |
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Provider Enumeration Date | 07/03/2024 |
Last Update Date | 07/15/2024 |
Medicare PECOS PAC ID | 6608308978 |
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Medicare Enrollment ID | O20241011003142 |
Identifier | Type | State | Issuer |
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1952147498 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Richard Lawrence Sherman |
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Provider Type | Practitioner - Geriatric Medicine |
Provider Identifiers | NPI Number: 1629050794 PECOS PAC ID: 8022089119 Enrollment ID: I20100610000824 |
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