# DEDICATED SOUTH CAROLINA HOLDING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DEDICATED SOUTH CAROLINA HOLDING, LLC
- **Other names:** Dedicated Senior Medical Center Forest
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1326788134
- **Legal business name:** DEDICATED SOUTH CAROLINA HOLDING, LLC
- **Authorized official:** MARY CHEN (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (305) 628-6117

## Contact information

- **Practice address:** 2571 FOREST DR, COLUMBIA, SC 29204-2029
- **Practice address phone:** (803) 610-4199
- **Practice address fax:** (803) 830-7157
- **Mailing address:** 1395 NW 167TH ST, MIAMI GARDENS, FL 33169-5710
- **Mailing address phone:** (305) 628-6117

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | Yes |

## Other

- **Enumeration date:** 03/30/2022
- **Last updated:** 03/30/2022