CAROLINA HEALTH CENTERS INC. NPI 1639202922

NPI Information

NPI: 1639202922
Provider Name: CAROLINA HEALTH CENTERS, INC.
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Doing Business As: THE PENDERGRASS FAMILY HEALTH CENTER
Address: 85 S GREENWOOD AVE
WARE SHOALS, SC
ZIP 29692
Phone: (864) 456-7436

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NPI Details

CAROLINA HEALTH CENTERS, INC. is a family medicine in Ware Shoals, SC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. CAROLINA HEALTH CENTERS, INC. NPI is 1639202922. The provider is registered as an organization entity type.
The provider Is Doing Business As The Pendergrass Family Health Center.

The provider's business location address is:

85 S GREENWOOD AVE
WARE SHOALS, SC
ZIP 29692-534
Phone: (864) 456-7436
Fax: (864) 456-2942

The provider's authorized official is Lisa Y Gilmer .
The authorized official title is Revenue Cycle Manager and has the following contact phone number (864) 941-8121.

The enumeration date for this NPI number is 3/14/2007 and was last updated on 10/24/2018.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			No
2	207Q00000X	Family Medicine				Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========005	OTHER	SOUTH CAROLINA	TRICARE PROVIDER NUMBER
2	FQC019	MEDICAID	SOUTH CAROLINA
3	=========011	OTHER	SOUTH CAROLINA	BLUE CROSS PROVIDER NUMBE

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: 3/30/2025

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