# 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:** 1841514163
- **Legal business name:** LITTLE RIVER MEDICAL CENTER, INC.
- **Authorized official:** MRS. AVANGELA K CRISWELL (BUSINESS OFFICE DIRECTOR)
- **Authorized official phone:** (843) 663-1013

## Contact information

- **Practice address:** 4303 LIVE OAK DR, LITTLE RIVER, SC 29566-9138
- **Practice address phone:** (843) 663-8017
- **Practice address fax:** (843) 663-1017
- **Mailing address:** PO BOX 547, LITTLE RIVER, SC 29566-0547
- **Mailing address phone:** (843) 663-8017
- **Mailing address fax:** (843) 663-1017

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 4406 | SC | Yes |

## Other

- **Enumeration date:** 03/15/2010
- **Last updated:** 07/20/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZA9656 | — | SC |