# ST BROACH LLC

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

## Provider details

- **NPI number:** 1477439511
- **Authorized official:** MRS. TASHA M BROACH NP-C (OWNER)
- **Authorized official phone:** (843) 260-8041

## Contact information

- **Practice address:** 908 S PARKER DR, FLORENCE, SC 29501-6007
- **Practice address phone:** (843) 260-8041
- **Mailing address:** 1841 SLOANE LN, FLORENCE, SC 29501-6532
- **Mailing address phone:** (843) 260-8041

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 08/13/2025
- **Last updated:** 08/13/2025