# BROAD RIVER PRIMARY CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Infectious Disease Associates of the Low Country
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518368307
- **Authorized official:** MR. WESLEY O. JAMES (REGIONAL CFO, TENET)
- **Authorized official phone:** (404) 265-5009

## Contact information

- **Practice address:** 25 HOSPITAL CENTER BLVD, SUITE 303A, HILTON HEAD, SC 29926-2738
- **Practice address phone:** (843) 682-1064
- **Practice address fax:** (843) 682-1063
- **Mailing address:** PO BOX 741720, ATLANTA, GA 30384-1720
- **Mailing address phone:** (843) 682-1064
- **Mailing address fax:** (843) 682-1063

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | — | NULL | Yes |
| 207RI0200X | Infectious Disease Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/11/2014
- **Last updated:** 05/26/2016