Little River Medical Center Inc

LBN: Little River Medical Center Inc
Little River Medical Center Inc is an health care organization with primary practice located at 4303 Live Oak Dr , Little River SC 29566-9138. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Dental Providers / Dentist is the primary health care specialty. Little River Medical Center Inc can be contacted via phone (843) 663-8000, or through Criswell, Avangela Kay via phone (843) 663-8017.

Contact Information

Primary practice address
4303 Live Oak Dr Little River SC 29566-9138
Fax: (843) 663-8154
Website:
Authorized official contact:
Name: Criswell, Avangela Kay

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 4406 South Carolina
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X

Profile Details

NPI number 1053471623
LBN Legal business name Little River Medical Center Inc
DBA Doing business as
Authorized official Criswell, Avangela Kay
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 12th, 2006
Last updated Nov 2nd, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053471623 NPPES
South Carolina MEDICAID ZA9656

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