| South Carolina My Care Team | |
|
201 Caughman Farm Ln Lexington SC 29072-7342 | |
| (803) 771-1993 | |
| Not Available |
| Full Name | South Carolina My Care Team |
|---|---|
| Speciality | Clinic/Center |
| Location | 201 Caughman Farm Ln, Lexington, South Carolina |
| Authorized Official Name and Position | Christopher Cooper (CEO) |
| Authorized Official Contact | 8036291900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Carolina My Care Team 214 Old Chapin Rd Lexington SC 29072-2030 Ph: (803) 629-1900 | South Carolina My Care Team 201 Caughman Farm Ln Lexington SC 29072-7342 Ph: (803) 771-1993 |
| NPI Number | 1588327050 |
|---|---|
| Provider Enumeration Date | 10/20/2021 |
| Last Update Date | 01/20/2023 |
| Medicare PECOS PAC ID | 2961897244 |
|---|---|
| Medicare Enrollment ID | O20220323002561 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588327050 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 282E00000X | Long Term Care Hospital | (* (Not Available)) | Secondary |
| Provider Name | Christopher A Cooper |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932511151 PECOS PAC ID: 0042519795 Enrollment ID: I20171031003418 |
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