| Premier Clincs | |
|
120 York St Chester SC 29706-1484 | |
| (803) 581-3000 | |
| (803) 581-2997 |
| Full Name | Premier Clincs |
|---|---|
| Speciality | Clinic/Center |
| Location | 120 York St, Chester, South Carolina |
| Authorized Official Name and Position | Bamidele a Ekunsanmi (PRESIDENT/CEO) |
| Authorized Official Contact | 8035813000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Clincs Po Box 159 120 York Street Chester SC 29706-0159 Ph: (803) 581-3000 | Premier Clincs 120 York St Chester SC 29706-1484 Ph: (803) 581-3000 |
| NPI Number | 1548282452 |
|---|---|
| Provider Enumeration Date | 07/24/2006 |
| Last Update Date | 02/29/2008 |
| Medicare PECOS PAC ID | 7315013463 |
|---|---|
| Medicare Enrollment ID | O20080915000120 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548282452 | NPI | - | NPPES |
| GP3015 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 19921 (South Carolina) | Primary |
| Provider Name | Bamidele a Ekunsanmi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932156171 PECOS PAC ID: 7012089311 Enrollment ID: I20080701000611 |
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