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Organization
CENTERWELL SENIOR PRIMARY CARE (SC) PC
Active
Organization
CENTERWELL SENIOR PRIMARY CARE (SC) PC
Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE (SC) PC
Other names
Partners in Primary Care, North Charleston, CenterWell Senior Primary Care-North Charleston, Partners in Primary Care NC PC, Partners in Primary Care SC PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTERWELL SENIOR PRIMARY CARE (SC) PC
Authorized official
ANGIE MARTINEZ (SENIOR CREDENTIALING PROFESSIONAL)
(407) 447-7120
Entity
Organization
Contact information
Practice address
1213 REMOUNT RD, NORTH CHARLESTON, SC 29406-3433
(843) 973-5415
(833) 994-1101
Mailing address
6101 BLUE LAGOON DR STE 200, MIAMI, FL 33126-3168
(305) 500-2000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP9109
—
SC
Enumeration date
03/25/2019
Last updated
08/19/2024
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