National Provider Identifier Database

EDISTO INDIAN FREE CLINIC FOUR HOLES INDIAN ORGANIZATION EDISTO TRIBAL INC
Clinic/Center

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).


Contact Information

EDISTO INDIAN FREE CLINIC
LBN FOUR HOLES INDIAN ORGANIZATION EDISTO TRIBAL INC.
1125 RIDGE RD
RIDGEVILLE, SC29472
Phone: 843-871-2126
Fax: 843-832-6019
Website:
Specialty Taxonomy Code
* Clinic/Center 261Q00000X

* Indicates primary specialty

NPI Profile & details for EDISTO INDIAN FREE CLINIC

NPI Number 1407250566
Legal business name
LBN
FOUR HOLES INDIAN ORGANIZATION EDISTO TRIBAL INC.
Doing business as
DBA
EDISTO INDIAN FREE CLINIC
Authorized official DONNIE CREEL - (CHAIRMAN OF THE BOARD)
Entity Organization
Organization subpart No
Enumeration date 10/20/2014
Last updated 07/21/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for EDISTO INDIAN FREE CLINIC

There are currently no reviews for EDISTO INDIAN FREE CLINIC


NPIdb - Home
v2.201