| Promed Preferred SC PC | |
|
317 Ruth Vista Rd Lexington SC 29073-8628 | |
| (615) 499-3165 | |
| Not Available |
| Full Name | Promed Preferred SC PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 317 Ruth Vista Rd, Lexington, South Carolina |
| Authorized Official Name and Position | Lev Grinman (PRESIDENT) |
| Authorized Official Contact | 6154993165 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Promed Preferred SC PC 329 S Oyster Bay Rd # 2059 Plainview NY 11803-3301 | Promed Preferred SC PC 317 Ruth Vista Rd Lexington SC 29073-8628 Ph: (615) 499-3165 |
| NPI Number | 1467333716 |
|---|---|
| Provider Enumeration Date | 09/11/2025 |
| Last Update Date | 09/11/2025 |
| Certification Date | 09/11/2025 |
| Medicare PECOS PAC ID | 8426548827 |
|---|---|
| Medicare Enrollment ID | O20251105000427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467333716 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Erin Salas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295486413 PECOS PAC ID: 1850786187 Enrollment ID: I20251204000296 |
| Provider Name | Marion Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134992985 PECOS PAC ID: 8921448762 Enrollment ID: I20260611002394 |
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