| Ketamine Solutions, Llc | |
|
138 Milestone Way Ste A Greenville SC 29615-6618 | |
| (864) 236-1630 | |
| Not Available |
| Full Name | Ketamine Solutions, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 138 Milestone Way Ste A, Greenville, South Carolina |
| Authorized Official Name and Position | Joy Bailley (MEMBER) |
| Authorized Official Contact | 8645271250 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ketamine Solutions, Llc 3523 Pelham Rd Ste C Greenville SC 29615-4191 Ph: (864) 527-1250 | Ketamine Solutions, Llc 138 Milestone Way Ste A Greenville SC 29615-6618 Ph: (864) 236-1630 |
| NPI Number | 1952147498 |
|---|---|
| Provider Enumeration Date | 07/03/2024 |
| Last Update Date | 07/15/2024 |
| Medicare PECOS PAC ID | 6608308978 |
|---|---|
| Medicare Enrollment ID | O20241011003142 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952147498 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Richard Lawrence Sherman |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1629050794 PECOS PAC ID: 8022089119 Enrollment ID: I20100610000824 |
| Provider Name | Lindsey Elizabeth Neal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073212478 PECOS PAC ID: 0749655801 Enrollment ID: I20230404001149 |
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