MEDICARE: SINGLETON HEALTH CENTER, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	14294	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	7440	OTHER	SC	MEDICARE PIN

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457303851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SINGLETON HEALTH CENTER, LLC

Provider Business Mailing Address
First Line	:	1773 VILLAGE PARK DR
Second Line	:
City	:	ORANGEBURG
State	:	SC
Zip	:	29118-2475
Country	:	US
Telephone Number	:	803-535-3600
Fax Number	:	803-534-6300

Provider Business Practice Location Address
First Line	:	119 BOLTIN AVE
Second Line	:
City	:	NORTH
State	:	SC
Zip	:	29112-8131
Country	:	US
Telephone Number	:	803-247-3900
Fax Number	:	803-247-3930

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

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	04/15/2008

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Directions to “SINGLETON HEALTH CENTER, LLC ” Practice Location

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