| Primary Choice Medical, Pa | |
|
9 Buena Vista Way Greenville SC 29615-6621 | |
| (864) 990-1825 | |
| (864) 284-0856 |
| Full Name | Primary Choice Medical, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 9 Buena Vista Way, Greenville, South Carolina |
| Authorized Official Name and Position | Ronald S Phillips (PRESIDENT) |
| Authorized Official Contact | 8649901825 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Choice Medical, Pa 9 Buena Vista Way Greenville SC 29615-6621 Ph: (864) 990-1825 | Primary Choice Medical, Pa 9 Buena Vista Way Greenville SC 29615-6621 Ph: (864) 990-1825 |
| NPI Number | 1891078606 |
|---|---|
| Provider Enumeration Date | 09/28/2011 |
| Last Update Date | 04/04/2012 |
| Medicare PECOS PAC ID | 0042485534 |
|---|---|
| Medicare Enrollment ID | O20111212000770 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891078606 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0342 (South Carolina) | Primary |
| Provider Name | Ronald Scott Phillips |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154388874 PECOS PAC ID: 7618954678 Enrollment ID: I20040728000078 |
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