Provider Demographics
NPI:1588327050
Name:SOUTH CAROLINA MY CARE TEAM
Entity type:Organization
Organization Name:SOUTH CAROLINA MY CARE TEAM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-629-1900
Mailing Address - Street 1:214 OLD CHAPIN RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-2030
Mailing Address - Country:US
Mailing Address - Phone:803-629-1900
Mailing Address - Fax:
Practice Address - Street 1:201 CAUGHMAN FARM LN
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-7342
Practice Address - Country:US
Practice Address - Phone:803-771-1993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No282E00000XHospitalsLong Term Care Hospital