Organization
CARESOUTH CAROLINA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANN LEWIS (CEO)
(843) 857-0111
Entity
Organization
Contact information
Practice address
737 S MAIN STREET, SOCIETY HILL, SC 29593
(843) 378-4501
(843) 378-4209
Mailing address
201 SOUTH FIFTH ST, HARTSVILLE, SC 29550
(843) 857-0111
(843) 857-0150
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9329
—
SC
Enumeration date
10/19/2010
Last updated
03/20/2017
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