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
3080 HIGHWAY 15-401 E, MC COLL, SC 29570-6128
(843) 523-5751
Mailing address
PO BOX 1090, HARTSVILLE, SC 29551-1090
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FQC063
—
SC
Enumeration date
06/14/2006
Last updated
06/17/2019
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