Organization
LITTLE RIVER MEDICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA R DAVIS (CEO)
(843) 663-1013
Entity
Organization
Contact information
Practice address
7726 N KINGS HWY, MYRTLE BEACH, SC 29572-3041
(843) 663-1013
(843) 663-1017
Mailing address
PO BOX 547, LITTLE RIVER, SC 29566-0547
(843) 663-1013
(843) 663-1017
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
183500000X
Pharmacist
—
—
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FQC065
—
SC
Enumeration date
01/28/2011
Last updated
12/09/2014
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