Provider Demographics
NPI:1134787641
Name:SELECT PHYSICIANS CARE
Entity type:Organization
Organization Name:SELECT PHYSICIANS CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-739-5001
Mailing Address - Street 1:PO BOX 2959
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29171-2959
Mailing Address - Country:US
Mailing Address - Phone:803-796-6490
Mailing Address - Fax:
Practice Address - Street 1:1 STILL HOPES DR
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-7164
Practice Address - Country:US
Practice Address - Phone:803-796-6490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTH CAROLINA EPISCOPAL HOME AT 'STILL HOPES'
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty