Provider Demographics
NPI:1467660019
Name:SENTINEL HEALTH PARTNERS, PA
Entity Type:Organization
Organization Name:SENTINEL HEALTH PARTNERS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:MCALPINE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:803-713-8350
Mailing Address - Street 1:PO BOX 1259
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29021-1259
Mailing Address - Country:US
Mailing Address - Phone:803-713-8350
Mailing Address - Fax:803-713-8433
Practice Address - Street 1:615 LAURENS ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:SC
Practice Address - Zip Code:29020-3523
Practice Address - Country:US
Practice Address - Phone:803-432-9874
Practice Address - Fax:803-432-8441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP1678Medicaid
SC5362Medicare PIN