Organization
ROBERT S. EAGERTON, JR. M.D.,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT S EAGERTON JR. M.D. (OWNER)
(803) 433-0439
Entity
Organization
Contact information
Practice address
200 E HOSPITAL ST, MANNING, SC 29102-3160
(803) 433-0439
(803) 433-9840
Mailing address
200 E HOSPITAL ST, MANNING, SC 29102-3160
(803) 433-0439
(803) 433-9840
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
11415
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700093705
—
SC
01
—
RHC1700093705
RHC RIVERBEND
SC
Enumeration date
05/17/2007
Last updated
03/31/2009
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