Prisma Health Primary Care Fountain Inn | |
200 N. Nelson Drive Fountain Inn SC 29644 | |
(864) 522-6270 | |
(864) 522-6275 |
Full Name | Prisma Health Primary Care Fountain Inn |
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Speciality | Clinic/Center |
Location | 200 N. Nelson Drive, Fountain Inn, South Carolina |
Authorized Official Name and Position | Polly H. Miller (VP, PAYOR STRATEGIES & ALIGNMENT) |
Authorized Official Contact | 8645222286 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Prisma Health Primary Care Fountain Inn 300 E Mcbee Ave Fl 4 Greenville SC 29601-2842 Ph: (864) 522-8603 | Prisma Health Primary Care Fountain Inn 200 N. Nelson Drive Fountain Inn SC 29644 Ph: (864) 522-6270 |
NPI Number | 1205414828 |
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Provider Enumeration Date | 04/02/2021 |
Last Update Date | 04/22/2022 |
Medicare PECOS PAC ID | 5698063162 |
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Medicare Enrollment ID | O20210422000284 |
Identifier | Type | State | Issuer |
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1205414828 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Prisma Health Primary Care Fountain Inn Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 N Nelson Dr, Fountain Inn, SC 29644 Phone: 864-522-6270 Fax: 864-522-6275 |