Provider Demographics
NPI:1457303851
Name:SINGLETON HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:SINGLETON HEALTH CENTER, LLC
Other - Org Name:MEDICAL CENTER OF NORTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGLETON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-535-3600
Mailing Address - Street 1:1773 VILLAGE PARK DR
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-2475
Mailing Address - Country:US
Mailing Address - Phone:803-535-3600
Mailing Address - Fax:803-534-6300
Practice Address - Street 1:119 BOLTIN AVE
Practice Address - Street 2:
Practice Address - City:NORTH
Practice Address - State:SC
Practice Address - Zip Code:29112-8131
Practice Address - Country:US
Practice Address - Phone:803-247-3900
Practice Address - Fax:803-247-3930
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SINGLETON HEALTH CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-16
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14294261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP3535Medicaid
SCRHC136Medicaid
SCRHC166Medicaid
SC7440OtherMEDICARE PIN
SCGP3535Medicaid
SC428965Medicare Oscar/Certification
SCCK3432Medicare PIN