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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- Homeland Park, Partners in Primary Care NC PC, Partners in Primary Care SC PC, CenterWell Senior Primary Care-Homeland Park
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
108 HIGHWAY 28 BYP, ANDERSON, SC 29624-3742
(864) 772-8173
(833) 996-1161
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
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP9170
—
SC
Enumeration date
07/17/2019
Last updated
08/19/2024
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