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Organization
EDISTO REGIONAL HEALTH SERVICES INC.
Active
Organization
EDISTO REGIONAL HEALTH SERVICES INC.
Active
Other names
Family Practice Associates of Holly Hill
Organization subpart
No
Provider details
NPI number
Authorized official
LISA M GOODLETT (C.O.O)
(803) 395-2462
Entity
Organization
Contact information
Practice address
187 BUNCH FORD ROAD, HOLLY HILL, SC 29059
(803) 496-3312
Mailing address
PO BOX 188, HOLLY HILL, SC 29059-0188
(803) 395-4480
(803) 395-4499
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP2353
—
SC
Enumeration date
05/08/2006
Last updated
04/15/2010
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