| Prisma Health-upstate | |
|
200 N Nelson Dr Fountain Inn SC 29644-9021 | |
| (864) 522-6270 | |
| (864) 522-6275 |
| Full Name | Prisma Health-upstate |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 200 N Nelson Dr, Fountain Inn, South Carolina |
| Authorized Official Name and Position | Polly H Miller (SVP FINANCE, ENTERPRISE CONTRACTING) |
| Authorized Official Contact | 8645222286 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prisma Health-upstate 300 E Mcbee Ave Fl 4 Greenville SC 29601-2842 Ph: () - | Prisma Health-upstate 200 N Nelson Dr Fountain Inn SC 29644-9021 Ph: (864) 522-6270 |
| NPI Number | 1164102927 |
|---|---|
| Provider Enumeration Date | 07/18/2023 |
| Last Update Date | 10/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164102927 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Prisma Health-upstate Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 200 N. Nelson Drive, Fountain Inn, SC 29644 Phone: 864-522-6270 Fax: 864-522-6275 |