Organization
LITTLE RIVER MEDICAL CENTER, INC.
Active
Parent organization
LITTLE RIVER MEDICAL CENTER, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
LITTLE RIVER MEDICAL CENTER, INC.
Authorized official
TAMMY PORTER (PROVIDER ENROLLMENT COORDINATOR)
(843) 663-8000
Entity
Organization
Contact information
Practice address
4220 CAROLINA EXCHANGE DR, MYRTLE BEACH, SC 29579-4220
(843) 663-8000
(843) 663-8166
Mailing address
PO BOX 547, LITTLE RIVER, SC 29566-0547
(843) 663-8294
(843) 663-8166
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
12/16/2024
Last updated
12/16/2024
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