Organization
SUMTER FAMILY HEALTH CENTER
Active
Parent organization
SUMTER FAMILY HEALTH CENTER
Other names
Sumter Family Health Center - Dental Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUMTER FAMILY HEALTH CENTER
Authorized official
ANNIE BROWN (CHIEF EXECUTIVE OFFICER)
(803) 774-4500
Entity
Organization
Contact information
Practice address
616 BULTMAN DR, SUITE #A, SUMTER, SC 29150-2593
(803) 774-4500
Mailing address
1278 N LAFAYETTE DR, SUMTER, SC 29150-2964
(803) 774-4500
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7124
MEDICARE
SC
05
—
FQC048
—
SC
Enumeration date
01/29/2016
Last updated
01/29/2016
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