Organization
SOUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
Active
Other names
Region 6 Department of Public Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COVIA LEVANCE STANLEY M.D., M.DIV. (REGIONAL HEALTH DIRECTOR)
(843) 915-8875
Entity
Organization
Contact information
Practice address
2830 OAK ST, CONWAY, SC 29526-4560
(843) 365-3126
(843) 365-3153
Mailing address
1931 INDUSTRIAL PARK RD, CONWAY, SC 29526
(843) 915-8875
(843) 365-3153
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
23550
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57-600-286
SC DHEC
SC
Enumeration date
05/14/2007
Last updated
07/18/2008
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