Provider Demographics
NPI:1578930053
Name:SOUTH CAROLINA MHT LLC
Entity Type:Organization
Organization Name:SOUTH CAROLINA MHT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERMAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:POSTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-744-2777
Mailing Address - Street 1:1515 HERITAGE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-3256
Mailing Address - Country:US
Mailing Address - Phone:972-616-4932
Mailing Address - Fax:
Practice Address - Street 1:1515 HERITAGE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3256
Practice Address - Country:US
Practice Address - Phone:972-616-4932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICA'S MEDICAL HOME TEAM INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty