Organization
CARESOUTH CAROLINA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN LEWIS (CEO)
(843) 857-0111
Entity
Organization
Contact information
Practice address
1268 S 4TH ST, HARTSVILLE, SC 29550-0703
(843) 332-3422
Mailing address
201 S 5TH ST, HARTSVILLE, SC 29550-4211
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CBP011
—
SC
05
—
FQC015
—
SC
Enumeration date
06/09/2005
Last updated
09/04/2007
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