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
812 STATE RD, CHERAW, SC 29520-7113
(843) 537-0961
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
—
CBP012
—
SC
05
—
FQC013
—
SC
Enumeration date
06/14/2006
Last updated
03/11/2024
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