# NEW RIVER UROLOGY PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194957548
- **Authorized official:** PAMELA S LANGLEY (ADMINISTRATOR)
- **Authorized official phone:** (843) 706-2255

## Contact information

- **Practice address:** 29 PLANTATION PARK DR, SUITE 202, BLUFFTON, SC 29910-9001
- **Practice address phone:** (843) 706-2255
- **Practice address fax:** (843) 706-2257
- **Mailing address:** PO BOX 2989, BLUFFTON, SC 29910-2989
- **Mailing address phone:** (843) 706-2255
- **Mailing address fax:** (843) 706-2257

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/19/2009
- **Last updated:** 03/07/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0321734 | — | SC |