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PRIMARY MEDICAL ASSOCIATION P.A. NPI 1174684112


NPI Information

NPI: 1174684112
Provider Name: PRIMARY MEDICAL ASSOCIATION, P.A.
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 42D0968616

Address:
1787 EBENEZER RD
ROCK HILL, SC
ZIP 29732
Phone: (803) 324-7777
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PRIMARY MEDICAL ASSOCIATION, P.A. is an internal medicine in Rock Hill, SC. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. PRIMARY MEDICAL ASSOCIATION, P.A. NPI is 1174684112. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1787 EBENEZER RD
ROCK HILL, SC
ZIP 29732-101
Phone: (803) 324-7777
Fax: (803) 324-8787

The provider's authorized official is Sushil Kumar Das .
The authorized official title is President and has the following contact phone number (803) 324-7777.

The CLIA number assigned to this NPI record is 42D0968616 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/13/2006 and was last updated on 7/23/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GP2808MEDICAIDSOUTH CAROLINA
2G419040282MEDICARE ID-TYPE UNSPECIFIEDSOUTH CAROLINA
3G41904MEDICARE UPINSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.