Provider Demographics
NPI:1336423193
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:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SANTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-488-6364
Mailing Address - Street 1:1708 OAK ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-3086
Mailing Address - Country:US
Mailing Address - Phone:843-248-4700
Mailing Address - Fax:843-248-3145
Practice Address - Street 1:1608 MAIN ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-3572
Practice Address - Country:US
Practice Address - Phone:843-248-4700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-09-28
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42D0857154291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ344140001Medicare PIN