# CENTERWELL SENIOR PRIMARY CARE (SC) PC

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- **Entity:** Organization
- **Status:** 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:** 1235699240
- **Legal business name:** CENTERWELL SENIOR PRIMARY CARE (SC) PC
- **Authorized official:** ANGIE MARTINEZ (SENIOR CREDENTIALING PROFESSIONAL)
- **Authorized official phone:** (407) 447-7120

## Contact information

- **Practice address:** 1213 REMOUNT RD, NORTH CHARLESTON, SC 29406-3433
- **Practice address phone:** (843) 973-5415
- **Practice address fax:** (833) 994-1101
- **Mailing address:** 6101 BLUE LAGOON DR STE 200, MIAMI, FL 33126-3168
- **Mailing address phone:** (305) 500-2000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 03/25/2019
- **Last updated:** 08/19/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP9109 | — | SC |