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General NPI Number Information
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NPI Number | 1255253951
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Entity Type | Organization
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Legal Business Name | SUNSET PRIMARY CARE
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Dates
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Enumeration Date | 07/27/2026
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Last Update Date | 07/27/2026
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Provider Practice Location Address
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Address Line | 2379 AUGUSTA RD
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-4541
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Country | US
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Telephone | 803-794-4877
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Fax | 803-794-4342
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Provider Business Mailing Address
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Address Line | 2379 AUGUSTA RD
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-4541
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Country | US
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Telephone | 803-794-4877
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Fax | 803-794-4342
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Authorized Official
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Title or Position | OWNER
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Name | SCOTTIE SHELLEY
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Credential |
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Telephone | 803-794-4877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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