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
MRS. AVANGELA KAY CRISWELL (BUSINESS OFFICE DIRECTOR)
(843) 663-1013
Entity
Organization
Contact information
Practice address
4950 SOCASTEE BLVD, MYRTLE BEACH, SC 29588-7239
(843) 293-7800
(843) 293-6331
Mailing address
PO BOX 547, SUITE 3, LITTLE RIVER, SC 29566-0547
(843) 663-1013
(843) 663-1017
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4406
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FQCO24
—
SC
05
—
ZA9656
—
NC
Enumeration date
11/15/2007
Last updated
03/29/2010
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