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General NPI Number Information
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NPI Number | 1184989840
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Entity Type | Organization
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Legal Business Name | SENTINEL HEALTH PARTNERS, PA
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Dates
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Enumeration Date | 07/09/2012
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Last Update Date | 05/12/2014
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Provider Practice Location Address
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Address Line | 1344 HAILE ST
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City | CAMDEN
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State | SC
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Zip | 29020-3076
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Country | US
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Telephone | 803-432-1996
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1259
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City | CAMDEN
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State | SC
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Zip | 29021-1259
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, I.T.
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Name | KIM BRAY
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Credential |
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Telephone | 803-713-8350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 42D0248605
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License Number State | SC
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