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Organization
KINGSTON FAMILY CARE
Active
Organization
KINGSTON FAMILY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE L SLOAN NP (OWNER)
(843) 839-9202
Entity
Organization
Contact information
Practice address
1511 B 9TH AVE, CONWAY, SC 29526-4107
(843) 839-9202
Mailing address
BOX 106, 4728 JENN DR, MYRTLE BEACH, SC 29577-5714
(843) 839-9202
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
26916
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4278
—
SC
Enumeration date
01/17/2006
Last updated
10/26/2007
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