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
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) 663-8000
(843) 663-1017
Mailing address
PO BOX 547, LITTLE RIVER, SC 29566-0547
(843) 663-8000
(843) 663-1017
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
SC
124Q00000X
Dental Hygienist
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
424024D
—
NC
05
—
ZA9656
—
SC
Enumeration date
04/04/2012
Last updated
04/04/2012
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