Organization
LITTLE RIVER MEDICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA R DAVIS MSN (CEO)
(843) 663-8001
Entity
Organization
Contact information
Practice address
3817 MAIN ST, LORIS, SC 29569-3017
(843) 663-8000
(843) 756-6828
Mailing address
PO BOX 547, LITTLE RIVER, SC 29566-0547
(843) 663-8000
(843) 663-1018
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FQC081
—
SC
Enumeration date
09/01/2009
Last updated
12/09/2014
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