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Contact Information

NORTHEAST ELITE MEDICAL CLINIC, LLC
136-4 FORUM DR
1018
COLUMBIA, SC29229
 Phone: 803-836-8679
 Fax: 803-800-2007
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Clinic/Center

261Q00000X
 

Urgent Care

261QU0200X
Indicates primary specialty

NPI Profile & details for NORTHEAST ELITE MEDICAL CLINIC LLC · (Female)

NPI # 1497322325
Status Active
Credentials
Entity Individual
Enumeration date 06/09/2021
Last updated 06/09/2021 - About 5 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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