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Contact Information

LITTLE RIVER MEDICAL CENTER, INC.
7724 N KINGS HWY
MYRTLE BEACH, SC29572-3041
 Phone: 843-839-3939
 Fax: 843-839-3946
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Federally Qualified Health Center (FQHC)

261QF0400X B4[14] Federally Qualified Health Center
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Dentist

122300000X
 

Family

363LF0000X 50 Nurse Practitioner
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for LITTLE RIVER MEDICAL CENTER, INC.

NPI Number 1184783284
LBN Legal business name LITTLE RIVER MEDICAL CENTER, INC.
Authorized official AVANGELA CRISWELL - (BUSINESS OFFICE DIRECTOR)
Entity Organization
Organization subpart 1 Yes
Enumeration date 12/06/2006
Last updated 12/09/2014 - About 12 years ago
Identifiers
SC Medicaid FQC065
SC Medicaid ZA9656
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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