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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 K CRISWELL (BUSINESS OFFICE DIRECTOR)
(843) 663-8017
Entity
Organization

Contact information

Practice address
4303 LIVE OAK DR, LITTLE RIVER, SC 29566-9138
(843) 663-8017
(843) 663-1017
Mailing address
PO BOX 547, LITTLE RIVER, SC 29566-0547
(843) 663-8017
(843) 663-1017

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4406
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZA9656
SC
Enumeration date
03/15/2010
Last updated
07/20/2012
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