| Primary Medical Association, P.a. | |
|
1787 Ebenezer Rd Rock Hill SC 29732-1101 | |
| (803) 324-7777 | |
| (803) 324-8787 |
| Full Name | Primary Medical Association, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1787 Ebenezer Rd, Rock Hill, South Carolina |
| Authorized Official Name and Position | Sushil Kumar Das (PRESIDENT) |
| Authorized Official Contact | 8033247777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Medical Association, P.a. 1410 Snyder St Rock Hill SC 29732-7721 Ph: (803) 324-7777 | Primary Medical Association, P.a. 1787 Ebenezer Rd Rock Hill SC 29732-1101 Ph: (803) 324-7777 |
| NPI Number | 1174684112 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 07/23/2012 |
| Medicare PECOS PAC ID | 4284890195 |
|---|---|
| Medicare Enrollment ID | O20120723000009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174684112 | NPI | - | NPPES |
| GP2808 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Sushil Kumar Das |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659353811 PECOS PAC ID: 4981645231 Enrollment ID: I20050517000353 |
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