| Elite Wellness Pa | |
|
9 Buena Vista Way Ste A Greenville SC 29615-6621 | |
| (864) 990-1825 | |
| (864) 284-0856 |
| Full Name | Elite Wellness Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 9 Buena Vista Way, Greenville, South Carolina |
| Authorized Official Name and Position | Nancy M Netter (OWNER) |
| Authorized Official Contact | 8649901825 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Wellness Pa 9 Buena Vista Way Ste A Greenville SC 29615-6621 Ph: (864) 990-1825 | Elite Wellness Pa 9 Buena Vista Way Ste A Greenville SC 29615-6621 Ph: (864) 990-1825 |
| NPI Number | 1619311099 |
|---|---|
| Provider Enumeration Date | 04/29/2013 |
| Last Update Date | 04/29/2013 |
| Medicare PECOS PAC ID | 8123253218 |
|---|---|
| Medicare Enrollment ID | O20131025001211 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619311099 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Sandra Love |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518913896 PECOS PAC ID: 3870568801 Enrollment ID: I20040901000644 |
| Provider Name | Nancy Mann Netter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093792426 PECOS PAC ID: 8022161561 Enrollment ID: I20090731000456 |
| Provider Name | Daniel G Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649439464 PECOS PAC ID: 3173701760 Enrollment ID: I20110630000250 |
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