Organization
EPICENTRE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENOSHA D GLEATON (OWNER)
(843) 804-6010
Entity
Organization
Contact information
Practice address
2679 LAKE PARK DR, NORTH CHARLESTON, SC 29406-9100
(843) 804-6010
Mailing address
2048 CHARLIE HALL BLVD, CHARLESTON, SC 29414-5830
(843) 804-6010
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
10/14/2025
Last updated
10/14/2025
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