Organization
LOW COUNTRY HEALTH CARE SYSTEM, INC.
Active
Other names
Family Medical Center of Blackville
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY L BARNES (CHIEF EXECUTIVE OFFICER)
(803) 632-2533
Entity
Organization
Contact information
Practice address
130 BAKER STREET, BLACKVILLE, SC 29817
(803) 284-1045
(803) 284-3094
Mailing address
86 WREN ST, BARNWELL, SC 29812-1529
(803) 259-5762
(803) 259-3250
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F785
MEDICARE PART B PTAN
SC
05
—
FQC077
—
SC
Enumeration date
10/05/2006
Last updated
01/11/2024
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