National Provider Identifier Database

NORTHEAST ELITE MEDICAL CLINIC LLC
Family


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
* Family 363LF0000X
Clinic/Center 261Q00000X
Urgent Care 261QU0200X

* Indicates primary specialty

NPI Profile & details for NORTHEAST ELITE MEDICAL CLINIC, LLC

NPI Number 1497322325
Legal business name
LBN
NORTHEAST ELITE MEDICAL CLINIC, LLC
Authorized official PAULETTE RUMPH - (CEO)
Entity Organization
Organization subpart No
Enumeration date 06/09/2021
Last updated 06/09/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers n/a

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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