Organization
TRIDENT MEDICAL SERVICES D/B/A TRIDENT SENIOR HEALTH CENTER
Active
Parent organization
TRIDENT MEDICAL CENTER
Other names
Trident Senior Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRIDENT MEDICAL CENTER
Authorized official
MS. KIMBERLIE DENMARK RN (DIRECTOR)
(843) 797-0416
Entity
Organization
Contact information
Practice address
9302 MEDICAL PLAZA DR, SUITE C, CHARLESTON, SC 29406-9142
(843) 797-0416
(843) 847-4477
Mailing address
9302 MEDICAL PLAZA DR, SUITE C, CHARLESTON, SC 29406-9142
(843) 797-0416
(843) 847-4477
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1196
—
SC
Enumeration date
08/17/2006
Last updated
03/24/2008
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