MEDICARE: PREMIER CLINICS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	19921	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548282452
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER CLINICS PA

Provider Business Mailing Address
First Line	:	PO BOX 159
Second Line	:	120 YORK STREET
City	:	CHESTER
State	:	SC
Zip	:	29706-0159
Country	:	US
Telephone Number	:	803-581-3000
Fax Number	:	803-581-2997

Provider Business Practice Location Address
First Line	:	120 YORK ST
Second Line	:
City	:	CHESTER
State	:	SC
Zip	:	29706-1484
Country	:	US
Telephone Number	:	803-581-3000
Fax Number	:	803-581-2997

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	DR. BAMIDELE A EKUNSANMI
Credential	:	MD
Telephone Number	:	803-581-3000

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	02/29/2008

Similar Medicare Providers

1194204990 — LETISHAL KELLY
Practice Location Address:

106 YORK ST
CHESTER, SC
29706-1484

Practice Phone: 704-493-0466
Practice Fax:

1770541591 — CHESTER VOLUNTEER AMBULANCE CORP
Practice Location Address:

79 LAROE RD
CHESTER, NY
10918-1484

Practice Phone: 845-469-4487
Practice Fax: 845-294-9656

1366877615 — DR. MAHMOUD AL SHEIKH ALI DDS
Practice Location Address:

10611 GREENYARD WAY
CHESTER, VA
23831-1484

Practice Phone: 804-717-2099
Practice Fax:

1174075436 — WALTER D. FELTON, DDS
Practice Location Address:

10611 GREENYARD WAY , STE A
CHESTER, VA
23831-1484

Practice Phone: 804-717-2099
Practice Fax: 804-717-9383

1841882313 — DR. BANSARI HARDIK PATEL DDS
Practice Location Address:

10611 GREENYARD WAY STE A
CHESTER, VA
23831-1484

Practice Phone: 804-717-2099
Practice Fax:

1205528742 — DAMEKE THOMPSON DDS
Practice Location Address:

10611 GREENYARD WAY STE A
CHESTER, VA
23831-1484

Practice Phone: 804-717-2099
Practice Fax:

Directions to “PREMIER CLINICS PA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.