Primary Medical Association, P.a. | |
1787 Ebenezer Rd Rock Hill SC 29732-1101 | |
(803) 324-7777 | |
(803) 324-8787 |
Full Name | Primary Medical Association, P.a. |
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Speciality | Internal Medicine |
Location | 1787 Ebenezer Rd, Rock Hill, South Carolina |
Authorized Official Name and Position | Sushil Kumar Das (PRESIDENT) |
Authorized Official Contact | 8033247777 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Primary Medical Association, P.a. 1410 Snyder St Rock Hill SC 29732-7721 Ph: (803) 324-7777 | Primary Medical Association, P.a. 1787 Ebenezer Rd Rock Hill SC 29732-1101 Ph: (803) 324-7777 |
NPI Number | 1174684112 |
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Provider Enumeration Date | 12/13/2006 |
Last Update Date | 07/23/2012 |
Medicare PECOS PAC ID | 4284890195 |
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Medicare Enrollment ID | O20120723000009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174684112 | NPI | - | NPPES |
GP2808 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Sushil Kumar Das |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1659353811 PECOS PAC ID: 4981645231 Enrollment ID: I20050517000353 |
Community Medicine Foundation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Piedmont St, Rock Hill, SC 29730 Phone: 803-325-7744 | |