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Organization
EPICENTRE, LLC
Active
Organization
EPICENTRE, LLC
Active
Other names
The EpiCentre, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENOSHA D GLEATON MD (MD/OWNER)
(843) 804-6010
Entity
Organization
Contact information
Practice address
2048 CHARLIE HALL BLVD, CHARLESTON, SC 29414
(843) 804-6010
(843) 804-6011
Mailing address
2048 CHARLIE HALL BLVD, CHARLESTON, SC 29414
(843) 804-6010
(843) 804-6011
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP9552
—
SC
05
—
PG0022
—
SC
Enumeration date
12/16/2019
Last updated
09/13/2024
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