Organization
MARION REGIONAL HEALTHCARE SYSTEM
Active
Other names
Pee Dee Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD E TUCKER (CHIEF EXECUTIVE OFFICER)
(843) 431-2405
Entity
Organization
Contact information
Practice address
2835 E HIGHWAY 76, SUITE 7, MULLINS, SC 29574-6038
(843) 431-2650
(843) 431-2647
Mailing address
PO BOX 1150, MARION, SC 29571-1150
(843) 431-2650
(843) 431-2647
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
RHC 121
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHC121
—
SC
Enumeration date
07/10/2006
Last updated
10/02/2008
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