# TIDELANDS GHS JOINT VENTURE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TIDELANDS GHS JOINT VENTURE LLC
- **Other names:** Tidelands Community Palliative Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1669878559
- **Legal business name:** TIDELANDS GHS JOINT VENTURE LLC
- **Authorized official:** JULIA DOAR STALVEY (CFO)
- **Authorized official phone:** (843) 546-3410

## Contact information

- **Practice address:** 2591 N FRASER ST, GEORGETOWN, SC 29440-6411
- **Practice address phone:** (843) 546-3410
- **Practice address fax:** (843) 527-6964
- **Mailing address:** 2591 N FRASER ST, GEORGETOWN, SC 29440-6411
- **Mailing address phone:** (843) 546-3410
- **Mailing address fax:** (843) 527-6964

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QH0002X | Hospice and Palliative Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QH0002X | Hospice and Palliative Medicine (Family Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/05/2014
- **Last updated:** 11/14/2023