NPIMap

Organization Active NPI

Chesterfield Marlboro LP

Doing business as Marlboro Primary Care Associates

  • Rural Health Clinic/Center
  • Bennettsville, SC
National Provider Identifier
1407978190
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CHESTERFIELD MARLBORO LP
Doing business as
Marlboro Primary Care Associates
Practice address
1040 Marlboro Way
Suite 1
Bennettsville, SC 29512-2494
Phone
(843) 479-5890
Fax
(843) 479-5893
NPI assigned
Apr 4, 2007
Organization subpart
Yes
Parent organization
CHESTERFIELD MARLBORO LPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

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

Authorized official

Name
Debbie T Brewer
Title
Director
Phone
(877) 892-9813

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1040 Marlboro Way
Suite 1
Bennettsville, SC 29512-2494

Mailing address

1040 Marlboro Way
Suite 1
Bennettsville, SC 29512-2494
Phone (843) 479-5890

Other identifiers 1

IdentifierTypeStateIssuer
RHC529MedicaidSC

Other names 1

  • Marlboro Primary Care Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Chesterfield Marlboro LP3 organizations share this tax ID, including this one
Part of
Chesterfield Marlboro LP

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317168000000",
    "number": "1407978190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 MARLBORO WAY",
            "address_2": "SUITE 1",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "295122494",
            "telephone_number": "843-479-5890",
            "fax_number": "843-479-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 MARLBORO WAY",
            "address_2": "SUITE 1",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "295122494",
            "telephone_number": "843-479-5890",
            "fax_number": "843-479-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTERFIELD MARLBORO LP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHESTERFIELD MARLBORO LP",
        "enumeration_date": "2007-04-04",
        "last_updated": "2011-09-28",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "877-892-9813"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC529",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marlboro Primary Care Associates",
            "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 Sep 28, 2011; 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.