Organization
GEORGETOWN PEDIATRIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE ANN AMANN MHA (ADMINSTRATOR)
(843) 546-8686
Entity
Organization
Contact information
Practice address
57 JESSAMINE AVE, GEORGETOWN, SC 29440-5837
(843) 546-8686
(843) 546-1353
Mailing address
PO BOX 618, GEORGETOWN, SC 29442-0618
(843) 546-8686
(843) 546-1353
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q84256
—
SC
Enumeration date
03/25/2014
Last updated
03/25/2014
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