Organization
PEE DEE HEALTHCARE PA
Active
Other names
Olanta Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONY R MEGNA JP (CEO)
(803) 799-1700
Entity
Organization
Contact information
Practice address
211 SOUTH JONES ROAD, OLANTA, SC 29114
(843) 396-9730
(843) 396-9735
Mailing address
3400 WEST AVE, COLUMBIA, SC 29203-6901
(803) 799-1700
(803) 254-3678
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHC126
—
SC
Enumeration date
09/17/2006
Last updated
03/05/2008
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