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PARTNERS FOR CHANGE OF THE CAROLINAS NPI 1356786750


NPI Information

NPI: 1356786750
Provider Name: PARTNERS FOR CHANGE OF THE CAROLINAS
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 42D2064995

Address:
110 SOUTH WASHINGTON STREET
SUMTER, SC
ZIP 29150
Phone: (803) 360-7896
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PARTNERS FOR CHANGE OF THE CAROLINAS is a multi-specialty clinic center in Sumter, SC. PARTNERS FOR CHANGE OF THE CAROLINAS NPI is 1356786750. The provider is registered as an organization entity type.

The provider's business location address is:

110 SOUTH WASHINGTON STREET
SUMTER, SC
ZIP 29150
Phone: (803) 360-7896
Fax: (803) 888-2648

The provider's authorized official is Valencia Giselle Gray-williams .
The authorized official title is Director and has the following contact phone number (803) 360-7896.

The CLIA number assigned to this NPI record is 42D2064995 - mobile laboratory with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/30/2013 and was last updated on 2/15/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM1300XClinic/CenterMulti-SpecialtyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1PENDINGMEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.