Little River Medical Center, Inc. | |
164 Waccamaw Medical Park Dr Conway SC 29526-8903 | |
(843) 347-4888 | |
(843) 663-1017 |
Full Name | Little River Medical Center, Inc. |
---|---|
Speciality | Counselor - Professional |
Location | 164 Waccamaw Medical Park Dr, Conway, South Carolina |
Authorized Official Name and Position | Avangela K Criswell (BUSINESS OFFICE DIRECTOR) |
Authorized Official Contact | 8436638017 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Little River Medical Center, Inc. Po Box 547 Little River SC 29566-0547 Ph: (843) 663-8000 | Little River Medical Center, Inc. 164 Waccamaw Medical Park Dr Conway SC 29526-8903 Ph: (843) 347-4888 |
NPI Number | 1073888400 |
---|---|
Provider Enumeration Date | 03/19/2012 |
Last Update Date | 03/19/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073888400 | NPI | - | NPPES |
FQC024 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 3657 (South Carolina) | Primary |
104100000X | Social Worker | 7136 (South Carolina) | Secondary |
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