Organization
LITTLE RIVER MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA R DAVIS (CEO)
(843) 663-8001
Entity
Organization
Contact information
Practice address
4303 LIVE OAK DR, LITTLE RIVER, SC 29566-9138
(843) 663-8000
(843) 280-2455
Mailing address
PO BOX 547, LITTLE RIVER, SC 29566-0547
(843) 663-8000
(843) 663-1017
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
SC
122300000X
Dentist
—
SC
163WD0400X
Diabetes Educator Registered Nurse
—
SC
183500000X
Pharmacist
—
SC
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
—
FQC024
—
SC
05
—
ZA9656
—
SC
Enumeration date
05/18/2006
Last updated
05/21/2014
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