MEDICARE: MEDICAL CENTER OF SANTEE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QP2300X	Primary Care Clinic/Center
2	207Q00000X	Family Medicine Physician
3	261QR1300X	Rural Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114935475
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL CENTER OF SANTEE LLC

Provider Business Mailing Address
First Line	:	500 BASS DRIVE
Second Line	:
City	:	SANTEE
State	:	SC
Zip	:	29142
Country	:	US
Telephone Number	:	803-854-3805
Fax Number	:	803-854-3810

Provider Business Practice Location Address
First Line	:	500 BASS DRIVE
Second Line	:
City	:	SANTEE
State	:	SC
Zip	:	29142
Country	:	US
Telephone Number	:	803-854-3805
Fax Number	:	803-854-3810

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. MONNIE SINGLETON
Credential	:	MD
Telephone Number	:	803-535-3600

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	08/26/2014

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Directions to “MEDICAL CENTER OF SANTEE LLC ” Practice Location

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