| Premier Medical Of Sc Llc | |
|
5880 Rivers Ave North Charleston SC 29406-6053 | |
| (843) 225-2374 | |
| (843) 459-1923 |
| Full Name | Premier Medical Of Sc Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5880 Rivers Ave, North Charleston, South Carolina |
| Authorized Official Name and Position | Karey Breen (MD) |
| Authorized Official Contact | 8432252374 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Medical Of Sc Llc 354 Folly Rd Ste 5 Charleston SC 29412-2594 Ph: (843) 225-2374 | Premier Medical Of Sc Llc 5880 Rivers Ave North Charleston SC 29406-6053 Ph: (843) 225-2374 |
| NPI Number | 1992276091 |
|---|---|
| Provider Enumeration Date | 12/16/2018 |
| Last Update Date | 05/10/2022 |
| Medicare PECOS PAC ID | 0042550386 |
|---|---|
| Medicare Enrollment ID | O20190322000975 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992276091 | NPI | - | NPPES |
| GP9928 | Medicaid | SC | |
| PG0752 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Deborah Ann Younger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134169808 PECOS PAC ID: 8527149376 Enrollment ID: I20080117000477 |
| Provider Name | Karey Breen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154582047 PECOS PAC ID: 2769530203 Enrollment ID: I20150127002052 |
| Provider Name | Selena O. Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346737673 PECOS PAC ID: 8426303843 Enrollment ID: I20180626000831 |
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