Organization
CAROLINA RURAL PRACTICE MANAGEMENT, INC.
Active
Other names
Wagner Medical Center, Williston Medical Center, Blackville Medical Ce
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLIE CLIFTON ALSBROOKS (ADMINISTRATOR)
(803) 641-6277
Entity
Organization
Contact information
Practice address
22 GARDNER RD, BLACKVILLE, SC 29817-3126
(803) 641-6277
Mailing address
22 GARDNER RD, P. O. BOX 247, BLACKVILLE, SC 29817-3126
(803) 641-6277
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0847
—
SC
Enumeration date
07/14/2008
Last updated
07/14/2008
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