# LITTLE RIVER MEDICAL CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LITTLE RIVER MEDICAL CENTER, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1477360188
- **Legal business name:** LITTLE RIVER MEDICAL CENTER, INC.
- **Authorized official:** TAMMY PORTER (PROVIDER ENROLLMENT COORDINATOR)
- **Authorized official phone:** (843) 663-8000

## Contact information

- **Practice address:** 4220 CAROLINA EXCHANGE DR, MYRTLE BEACH, SC 29579-4220
- **Practice address phone:** (843) 663-8000
- **Practice address fax:** (843) 663-8166
- **Mailing address:** PO BOX 547, LITTLE RIVER, SC 29566-0547
- **Mailing address phone:** (843) 663-8294
- **Mailing address fax:** (843) 663-8166

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QF0400X | Federally Qualified Health Center (FQHC) | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/16/2024
- **Last updated:** 12/16/2024