Organization
PREMIER CLINICS OF ROCK HILL
Active
Other names
PREMIER CLINICS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BAMIDELE A EKUNSANMI M.D (PRESIDENT/MEDICAL DIRECTOR)
(803) 326-3000
Entity
Organization
Contact information
Practice address
1609 CONSTITUTION BLVD, ROCK HILL, SC 29732-3047
(803) 326-3000
Mailing address
PO BOX 36291, ROCK HILL, SC 29732-0504
(803) 326-3000
(803) 326-3003
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
2019921
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3014
—
SC
Enumeration date
07/29/2006
Last updated
11/04/2008
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