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Contact Information

LITTLE RIVER MEDICAL CENTER, INC.
3817 MAIN ST
LORIS, SC29569-3017
 Phone: 843-663-8000
 Fax: 843-756-6828
 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
 

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 1619100096
LBN Legal business name LITTLE RIVER MEDICAL CENTER, INC.
Authorized official PAMELA DAVIS - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 09/01/2009
Last updated 12/09/2014 - About 12 years ago
Identifiers
SC Medicaid FQC081
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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