| Onsite Home Primary Care | |
|
105 Franklin Square Way Ste A Easley SC 29642-3715 | |
| (864) 442-4110 | |
| (864) 442-4126 |
| Full Name | Onsite Home Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 105 Franklin Square Way Ste A, Easley, South Carolina |
| Authorized Official Name and Position | Joel Childers (COO) |
| Authorized Official Contact | 8033414101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Onsite Home Primary Care 105 Franklin Square Way Ste A Easley SC 29642-3715 Ph: (864) 442-4110 | Onsite Home Primary Care 105 Franklin Square Way Ste A Easley SC 29642-3715 Ph: (864) 442-4110 |
| NPI Number | 1730966110 |
|---|---|
| Provider Enumeration Date | 09/11/2023 |
| Last Update Date | 10/09/2023 |
| Medicare PECOS PAC ID | 6204284839 |
|---|---|
| Medicare Enrollment ID | O20231121000595 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730966110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Gerlanda Derr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205072808 PECOS PAC ID: 5890847784 Enrollment ID: I20191018002118 |
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