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Organization

SC REGIONAL HEALTH SYSTEM LLC

Active
Other names
Blackville Family Medicine
Organization subpart
No

Provider details

NPI number
Authorized official
MARY T. VALLIANT (CEO)
(803) 541-4365
Entity
Organization

Contact information

Practice address
22 GARDNER RD, BLACKVILLE, SC 29817-3126
(803) 284-2041
(803) 284-5516
Mailing address
811 REYNOLDS RD, ATTN: CLINIC BUSINESS OFFICE, BARNWELL, SC 29812-1573
(803) 284-2041
(803) 284-5516

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
07/02/2012
Last updated
07/02/2012
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