Organization
ST BROACH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TASHA M BROACH NP-C (OWNER)
(843) 260-8041
Entity
Organization
Contact information
Practice address
908 S PARKER DR, FLORENCE, SC 29501-6007
(843) 260-8041
Mailing address
1841 SLOANE LN, FLORENCE, SC 29501-6532
(843) 260-8041
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/13/2025
Last updated
08/13/2025
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