NPIMap

Organization Active NPI

Marlboro Clinic Corp

Doing business as Marlboro Women's Health

  • Obstetrics & Gynecology Physician
  • Bennettsville, SC
National Provider Identifier
1275692501
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
MARLBORO CLINIC CORP
Doing business as
Marlboro Women's Health
Practice address
1040 Marlboro Way
Suite 8
Bennettsville, SC 29512-2494
Phone
(843) 454-1100
Fax
(843) 454-0110
NPI assigned
Dec 6, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
MARLBORO CLINIC CORPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Debbie T Brewer
Title
Provider Enrollment
Phone
(800) 709-7345

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

1040 Marlboro Way
Suite 8
Bennettsville, SC 29512-2494

Mailing address

1040 Marlboro Way
Suite 8
Bennettsville, SC 29512-2494
Phone (843) 454-1100

Other names 1

  • Marlboro Women's Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Marlboro Clinic Corporation2 organizations share this tax ID, including this one
Part of
Marlboro Clinic Corporation

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1040 Marlboro Way
Ste 8
Bennettsville, SC 29512
Phone (843) 454-1100

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1275692501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 MARLBORO WAY",
            "address_2": "SUITE 8",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "295122494",
            "telephone_number": "843-454-1100",
            "fax_number": "843-454-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 MARLBORO WAY",
            "address_2": "SUITE 8",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "295122494",
            "telephone_number": "843-454-1100",
            "fax_number": "843-454-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLBORO CLINIC CORP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARLBORO CLINIC CORP",
        "enumeration_date": "2006-12-06",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "800-709-7345"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marlboro Women's Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bennettsville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.