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NPI Code Detail

MEDICARE: PREMISE HEALTH OF SOUTH CAROLINA MEDICAL PC

MEDICARE: PREMISE HEALTH OF SOUTH CAROLINA MEDICAL PC
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
1261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1700202819
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMISE HEALTH OF SOUTH CAROLINA MEDICAL PC
Provider Business Mailing Address
First Line : 5500 MARYLAND WAY
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-7048
Country : US
Telephone Number : 888-830-4255
Fax Number :
Provider Business Practice Location Address
First Line : 2480 TWO NOTCH RD
Second Line :
City : LEXINGTON
State : SC
Zip : 29072-7963
Country : US
Telephone Number : 803-951-5871
Fax Number : 803-951-5872
Authorized Official
Title or Position : PRESIDENT
Name : EDWARD WILLIAM SCHWARTZ
Credential :
Telephone Number : 844-407-7557
Provider Enumeration Date : 03/13/2014
Last Update Date : 03/09/2026

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Directions to “PREMISE HEALTH OF SOUTH CAROLINA MEDICAL PC ” Practice Location

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