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General NPI Number Information
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NPI Number | 1477496644
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Entity Type | Organization
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Legal Business Name | MOLINA HEALTHCARE OF SOUTH CAROLINA, INC.
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Dates
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Enumeration Date | 04/13/2026
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Last Update Date | 04/13/2026
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Provider Practice Location Address
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Address Line | 115 FAIRCHILD ST STE 340
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City | DANIEL ISLAND
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State | SC
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Zip | 29492-7602
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Country | US
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Telephone | 843-680-1943
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Fax |
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Provider Business Mailing Address
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Address Line | 115 FAIRCHILD ST STE 340
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City | DANIEL ISLAND
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State | SC
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Zip | 29492-7602
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Country | US
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Telephone | 843-680-1943
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Fax |
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Authorized Official
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Title or Position | PLAN PRESIDENT
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Name | WILLIAM R PHIPPS
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Credential |
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Telephone | 843-680-1943
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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