Organization
GEORGETOWN PHYSICIAN ASSOCIATES, LLC
Active
Other names
Tidelands Health Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH SUTHERLAND WARD (EVP & CFO)
(843) 527-7102
Entity
Organization
Contact information
Practice address
701 S MORGAN AVE, ANDREWS, SC 29510
(843) 264-5253
(843) 264-5970
Mailing address
PO BOX 421718, GEORGETOWN, SC 29442-4203
(843) 520-8330
(843) 652-8422
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHC068
—
SC
Enumeration date
11/06/2006
Last updated
05/01/2020
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