Lifesource Prime Inc

LBN: Lifesource Prime Inc
Lifesource Prime Inc is an health care organization with primary practice located at 939 Springdale Dr , Clinton SC 29325-7266. The organization recently has 8 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / General Practice, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Lifesource Prime Inc can be contacted via phone (910) 742-9243, or through Baddour, Peggy via phone (910) 742-9243.

Contact Information

Primary practice address
939 Springdale Dr Clinton SC 29325-7266
Phone: (910) 742-9243
Fax: (888) 746-1787
Website:
Map and Directions
Authorized official contact:
Name: Baddour, Peggy
Phone: (910) 742-9243

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Allopathic & Osteopathic Physicians / General Practice 208D00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X

Profile Details

NPI number 1851143523
LBN Legal business name Lifesource Prime Inc
DBA Doing business as
Authorized official Baddour, Peggy
Entity Organization
Organization subpart 1 No
Enumeration date Apr 4th, 2024
Last updated Apr 4th, 2024 - about 8 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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