ELITE MEDICAL CENTER LLC (NPI# 1730727009) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730727009 |
| Entity Type | Organization |
| Organization Name | ELITE MEDICAL CENTER LLC |
| Other Organization Name | ELITE MEDICAL CENTER |
| Practice Address |
12 Groce Rd Lyman SC 29365-1631 |
| Practice Telephone | 8644391345 |
| Practice Fax Number | 8644391346 |
| Mailing Telephone | 8644391345 |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2020-05-11 |
| Authorized Official Name | KEVIN PRIME (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 7044734653 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Elite Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083118145 | Elite Medical Center LLC | Clinic/Center | 150 E Harmon Ave, Las Vegas, NV 89109-4533 | 2018-03-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | ELITE MEDICAL CENTER LLC | 1350 Se 122nd Ave, Portland, OR 97233 |
| Street Address |
12 GROCE RD |
| City | LYMAN |
| State | SC |
| Zip Code | 29365-1631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134202427 | Wellford Chiropractic | Chiropractor | 12 Groce Rd, Lyman, SC 29365-1631 | 2006-10-23 |
| 1578033965 | Elite Wellness Center LLC | Chiropractor | 12 Groce Rd, Lyman, SC 29365-1631 | 2018-11-28 |
| 1770016370 | Jennifer Campa | Chiropractor | 12 Groce Rd, Lyman, SC 29365-1631 | 2017-04-10 |
| 1407234537 | Bruce Chiropractic Wellness Center | Chiropractor | 12 Groce Rd, Lyman, SC 29365-1631 | 2015-05-08 |
| 1649689969 | Kevin Prime | Chiropractor | 12 Groce Rd, Lyman, SC 29365-1631 | 2014-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902203813 | Stephanie Walker | Nurse Practitioner | 1295 Old Spartanburg Hwy, Careteam Health, Lyman, SC 29365 | 2014-11-21 |
| 1013356161 | Tyger River Pediatric Dentistry | Dentist | 312 Spartanburg Hwy., Lyman, SC 29365 | 2013-06-21 |
| 1649436791 | Ashlan Village Retirement Community | Assisted Living Facility | 415 Brenda Way, Lyman, SC 29365 | 2008-07-29 |
| 1538379086 | Lyman Dental Associates PC | Dentist | 301 Old Spartanburg Rd., Lyman, SC 29365 | 2007-05-23 |
| 1437297462 | Tina Louise Gaudiano | Counselor | 84 Groce Rd, Lyman, SC 29365 | 2007-02-02 |
| 1255477014 | Cathy Ford Sparks | Counselor | Middle Tyger Community Center, 84 Grace Rd, Lyman, SC 29365 | 2007-01-29 |
| 1194828657 | Kirk E Houston Dmd Pa | Dentist | 12313 Greenville Highway, Lyman, SC 29365 | 2006-09-07 |
| 1245347210 | Grady Stoddard Brooks Jr. | Dentist | 301 Old Spartanburg Road, Lyman, SC 29365 | 2006-08-24 |
| 1750494894 | Brian Kingston Armstrong | Dentist | 350 S Spartanburg Hwy, Lyman, SC 29365 | 2006-08-15 |
| 1164456075 | John Blair Pierce | Physical Therapy Assistant | 104 Gwendolyn Aevnue, Lyman, SC 29365 | 2006-07-10 |
| Find all providers in zip 29365 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912253 | Life Essentials Health Center LLC | General Practice | 1501 N Highway 17 Unit H, Mount Pleasant, SC 29464-3342 | 2020-11-04 |
| 1710591706 | Madhuri Khadka | General Practice | 427 Galbreath Ct, Fort Mill, SC 29708-0176 | 2020-09-07 |
| 1255945754 | Escobedo Advanced Healthcare Solutions LLC | General Practice | 121 Sparkleberry Crossing Rd Ste 200, Columbia, SC 29229-8639 | 2020-09-02 |
| 1306326640 | Orange Cut Rate Drug Store, Inc | General Practice | 1326 Grove Park Dr, Orangeburg, SC 29115 | 2018-08-16 |
| 1841704244 | Modern Concepts, LLC | General Practice | 1808 Second Baxter Xing Ste 108, Fort Mill, SC 29708 | 2017-11-21 |
| 1245744937 | Carolina Healthchoice of Greenville, LLC | General Practice | 274 Commonwealth Dr Ste B, Greenville, SC 29615-4872 | 2017-11-17 |
| 1861937377 | Doctors Care Sc, Pa | General Practice | 8384 Charlotte Highway, Indian Land, SC 29707-6532 | 2016-12-20 |
| 1790138014 | Beaufort-jasper-hampton Comprehensive Health Services Inc. | General Practice | 2210-b Mossy Oaks Rd., Port Royal, SC 29935-1046 | 2016-07-21 |
| 1659726438 | Inspire Medical Services | General Practice | 104 Berkeley Square Ln, Ste 63, Goose Creek, SC 29445-2958 | 2016-04-28 |
| 1609240910 | Eating Recovery Center-the Carolinas | General Practice | 12 Maple Tree Court, Suite 101, Greenville, SC 29615-4079 | 2015-11-24 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ELITE MEDICAL CENTER LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.