Provider Demographics
NPI:1770668824
Name:HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.
Entity Type:Organization
Organization Name:HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR HUMAN RESOURCES
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:EUBANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-488-6363
Mailing Address - Street 1:145 PALMETTO POINTE RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:SC
Mailing Address - Zip Code:29571-3014
Mailing Address - Country:US
Mailing Address - Phone:843-423-2400
Mailing Address - Fax:843-423-2070
Practice Address - Street 1:145 PALMETTO POINTE RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:SC
Practice Address - Zip Code:29571-3014
Practice Address - Country:US
Practice Address - Phone:843-423-2400
Practice Address - Fax:843-423-2070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCFQC150Medicaid