Healthcare Provider Details
I. General information
NPI: 1952519662
Provider Name (Legal Business Name): SENTINEL HEALTH PARTNERS, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/18/2007
Last Update Date: 07/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1004 EMANUEL ST
ELGIN SC
29045-8335
US
IV. Provider business mailing address
PO BOX 1259
CAMDEN SC
29021-1259
US
V. Phone/Fax
- Phone: 803-438-7698
- Fax: 803-438-7563
- Phone: 803-713-8350
- Fax: 803-713-8433
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JAMES
C
MCALPINE
JR.
Title or Position: CEO
Credential: MD
Phone: 803-713-8350