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EVERSIDE HEALTH CENTER-MICHELIN ANDERSON NPI 1487321147


NPI Information

NPI: 1487321147
Provider Name: EVERSIDE HEALTH CENTER-MICHELIN ANDERSON
Classification: Preventive Medicine - 2083P0500X
Entity Type: Organization

Specialization: Preventive Medicine/Occupational Environmental Medicine

CLIA Number: 42D2240638

Address:
955 BOSCOBEL RD
ANDERSON, SC
ZIP 29625
Phone: (864) 375-0893
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EVERSIDE HEALTH CENTER-MICHELIN ANDERSON is a preventive medicine/occupational environmental medicine preventive medicine in Anderson, SC. The provider is a preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. EVERSIDE HEALTH CENTER-MICHELIN ANDERSON NPI is 1487321147. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

955 BOSCOBEL RD
ANDERSON, SC
ZIP 29625-704
Phone: (864) 375-0893

The provider's authorized official is Jill Johnson Patton .
The authorized official title is Director Of Risk Management and has the following contact phone number (704) 936-5546.

The CLIA number assigned to this NPI record is 42D2240638 - other - chronic disease mgt with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/30/2021 and was last updated on 12/1/2021.


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
12083P0500XPreventive MedicinePreventive Medicine/Occupational Environmental MedicineYes

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: 4/28/2024

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