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Organization
CAROLINA COMMUNITY MATERNITY CENTER
Active
Organization
CAROLINA COMMUNITY MATERNITY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA MARIE JOHNSON LICENSED MIDWIFE (CO-OWNER/PARTNER)
(803) 802-9494
Entity
Organization
Contact information
Practice address
2848 PLEASANT RD STE 101, FORT MILL, SC 29708-9494
(803) 802-9494
(877) 802-1901
Mailing address
2848 PLEASANT RD STE 101, FORT MILL, SC 29708-9494
(803) 802-9494
(877) 802-1901
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
BC-0009
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679704043
—
SC
Enumeration date
12/19/2014
Last updated
12/19/2014
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