Healthcare Provider Details
I. General information
NPI: 1689879264
Provider Name (Legal Business Name): SENTINEL HEALTH PARTNERS, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/15/2007
Last Update Date: 10/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
615 LAURENS ST
CAMDEN SC
29020-3523
US
IV. Provider business mailing address
PO BOX 1259
CAMDEN SC
29021-1259
US
V. Phone/Fax
- Phone: 803-432-9874
- Fax: 803-432-8441
- Phone: 803-713-8350
- Fax: 803-713-8433
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JAMES
C.
MCALPINE
JR.
Title or Position: CEO
Credential: MD
Phone: 803-438-1806