Organization
CARESOUTH CAROLINA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN LEWIS (CEO)
(843) 857-0111
Entity
Organization
Contact information
Practice address
737 S MAIN ST, SOCIETY HILL, SC 29593-8972
(843) 378-4501
Mailing address
PO BOX 1090, HARTSVILLE, SC 29551-1090
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CBP013
—
SC
05
—
FQC003
—
SC
Enumeration date
06/04/2006
Last updated
09/04/2007
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