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NPI Code Detail

MEDICARE: PRI-CARE INC

MEDICARE: PRI-CARE INC
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
1207R00000XInternal Medicine Physician23570SC

General Provider Information

NPI Number : 1700316106
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRI-CARE INC
Provider Business Mailing Address
First Line : 1735 HECKLE BLVD STE 103-303
Second Line :
City : ROCK HILL
State : SC
Zip : 29732-4803
Country : US
Telephone Number : 803-524-1821
Fax Number : 704-380-9117
Provider Business Practice Location Address
First Line : 1795 FRANK GASTON BLVD
Second Line :
City : ROCK HILL
State : SC
Zip : 29732-1190
Country : US
Telephone Number : 803-524-1821
Fax Number : 704-380-9117
Authorized Official
Title or Position : CEO
Name : TOLULOLA O. ADEOLA
Credential : MD
Telephone Number : 803-524-1821
Provider Enumeration Date : 06/18/2017
Last Update Date : 06/18/2017

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Directions to “PRI-CARE INC ” Practice Location

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