Lifesource Prime INC
NPI #1851143523 in Clinton, South Carolina
Provider Information
- NPI Number
- 1851143523
- Entity Type
- Organization
- Organization Name
- Lifesource Prime INC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Apr 4, 2024
- Last Updated
- Oct 28, 2025
Practice Location
- Address
- 939 SPRINGDALE DR
- City
- Clinton
- State
- South Carolina
- ZIP Code
- 29325-7266
- Phone
- (910) 742-9243
Authorized Official
- Name
- PEGGY BADDOUR
- Title
- PRESIDENT/OWNER
- Phone
- (910) 742-9243
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner |
| Internal Medicine |
| Nurse Practitioner - Gerontology — Gerontology |
| Nurse Practitioner - Primary Care — Primary Care |
| Nurse Practitioner - Family — Family |
| General Practice |
| Physician Assistant |
| Family Medicine |
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