NPIMap

Organization Active NPI

Dedicated South Carolina Holding, LLC

Doing business as Dedicated Senior Medical Center Forest TC

  • Non-Pharmacy Dispensing Site
  • Columbia, SC
National Provider Identifier
1295469245
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
DEDICATED SOUTH CAROLINA HOLDING, LLC
Doing business as
Dedicated Senior Medical Center Forest TC
Practice address
1022 Calhoun St # 201
Columbia, SC 29201-2406
Phone
(803) 610-4199
Fax
(803) 830-5446
NPI assigned
Jul 14, 2022
Last updated
Feb 1, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
DEDICATED SOUTH CAROLINA HOLDING, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Authorized official

Name
Mary Chen
Title
Authorized Official
Phone
(786) 618-7245

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

1022 Calhoun St # 201
Columbia, SC 29201-2406

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (305) 628-6117

Other names 1

  • Dedicated Senior Medical Center Forest TC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dedicated South Carolina Holding LLC3 organizations share this tax ID, including this one
Part of
Dedicated South Carolina Holding LLC

Other organizations with this tax ID 2

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

Locations

1022 Calhoun St
#201
Columbia, SC 29201
Phone (803) 610-4199

Practitioners & affiliated clinicians

Practitioners 2

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": "1657756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675209600000",
    "number": "1295469245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 CALHOUN ST # 201",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012406",
            "telephone_number": "803-610-4199",
            "fax_number": "803-830-5446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEDICATED SOUTH CAROLINA HOLDING, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEDICATED SOUTH CAROLINA HOLDING, LLC",
        "enumeration_date": "2022-07-14",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "786-618-7245"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dedicated Senior Medical Center Forest TC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dedicated Senior Medical Center Forest TC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.