TRIDENT MEDICAL CENTER, LLC (NPI# 1063813111) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063813111 |
| Entity Type | Organization |
| Organization Name | TRIDENT MEDICAL CENTER, LLC |
| Other Organization Name | CENTRE POINTE EMERGENCY OF TRIDENT MEDICAL CENTER |
| Practice Address |
5249 Emmett I. Davis Jr. Avenue North Charleston SC 29405 |
| Practice Telephone | 8437462400 |
| Practice Fax Number | 8437449700 |
| Mailing Telephone | 8437462400 |
| Mailing Fax Number | 8437449700 |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2019-10-31 |
| Authorized Official Name | ANDY S. MILLER (CFO) |
| Authorized Official Telephone | 8438474100 |
| Is Organization Subpart | Y |
| Parent Organization Name | TRIDENT MEDICAL CENTER, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0002X |
Clinic/Center Specialization: Emergency Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Centre Pointe Emergency of Trident Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124443478 | Trident Medical Center, LLC | Psychiatric Unit | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2014-02-24 |
| 1598189797 | Trident Medical Center, LLC | Rehabilitation Unit | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2014-02-07 |
| 1659579084 | Trident Medical Center, LLC | General Acute Care Hospital | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2007-07-06 |
| 1912029612 | Trident Medical Center, LLC | Clinic/Center | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2007-04-04 |
| 1386721405 | Trident Medical Center, LLC | General Acute Care Hospital | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2006-11-01 |
| 1932282258 | Trident Medical Center, LLC | Skilled Nursing Facility | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2006-10-23 |
| 1861447773 | Trident Medical Center, LLC | General Acute Care Hospital | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2006-05-23 |
| 1588619498 | Trident Medical Center, LLC | Skilled Nursing Facility | 9330 Medical Plaza Dr, Charleston, SC 29406-9104 | 2006-05-23 |
| Street Address |
5249 EMMETT I. DAVIS JR. AVENUE |
| City | NORTH CHARLESTON |
| State | SC |
| Zip Code | 29405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720535 | Detyens Medical Center | Pharmacy | 1670 Drydock Avenue, Building 10, Suite A, North Charleston, SC 29405 | 2020-11-03 |
| 1013422674 | Caroline Rae | Speech-Language Pathologist | 3100 Carner Avenue, Charleston, SC 29405 | 2017-12-05 |
| 1245685171 | Ethel Jane Amerson | Registered Nurse | 3180 Thomasena Mcpherson Blvd, Nursing Module, Charleston County School Districe, North Charleston, SC 29405 | 2016-04-28 |
| 1750755468 | Diane Levesque | Registered Nurse | 4050 Bridgeview Drive, Suite 600, North Charleston, SC 29405 | 2015-11-18 |
| 1114344504 | Bonita Davies | Registered Nurse | 3180 Thomasina Mcpherson Boulevard, North Charleston, SC 29405 | 2014-03-24 |
| 1427493261 | Melissa Hancock D'arcy | Registered Nurse | 3750 Dorchester Road, N. Charleston, SC 29405 | 2013-05-07 |
| 1427308824 | Terri Timmerman | Pharmacist | 1506 Montague Ave, North Charleston, SC 29405 | 2012-09-12 |
| 1649414285 | Roper Saint Francis Physicians Network | Clinical Medical Laboratory | 4450 Leeds Place West, Suite A, North Charleston, SC 29405 | 2009-04-27 |
| 1891940649 | Earnestine Roberts | Registered Nurse | 3605 Meeting Street Rd., Ste.b1, North Charleston, SC 29405 | 2008-11-20 |
| 1295989267 | Omega Private Home Care Service | Home Health | 4712 Durant Ave., North Charleston, SC 29405 | 2008-11-04 |
| Find all providers in zip 29405 | ||||
| Taxonomy Code | 261QE0002X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Emergency Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063586618 | George A. Wilkinson, Md Pa | Clinic/Center | 4033 Hwy 17 Bypass, Murrells Inlet, SC 29576-5032 | 2006-11-17 |
| 1073686994 | Kershawhealth | Clinic/Center | 1315 Roberts St, Camden, SC 29020-3737 | 2006-11-16 |
| 1336222884 | Palmetto Emergency Physicians, LLC | Clinic/Center | 730 Stoney Landing Rd, Moncks Corner, SC 29461-2948 | 2006-10-20 |
| 1700828084 | York Emergency Physicians | Clinic/Center | 222 S Herlong Ave, Rock Hill, SC 29732-1158 | 2006-06-12 |
| 1699729939 | Spartanburg Medical Center | Clinic/Center | 101 E Wood St, Emergency Center, Spartanburg, SC 29303-3040 | 2006-05-20 |
| City | NORTH CHARLESTON |
| Zip Code | 29405 |
Please comment or provide details below to improve the information on TRIDENT MEDICAL CENTER, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.