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Contact Information

CARESOUTH CAROLINA, INC
204 PERRY WILEY WAY
CHESTERFIELD, SC29709-5701
 Phone: 843-623-5080
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Federally Qualified Health Center (FQHC)

261QF0400X B4[14] Federally Qualified Health Center
Indicates primary specialty

NPI Profile & details for CARESOUTH CAROLINA, INC

NPI # 1629015755
LBN Legal business name CARESOUTH CAROLINA, INC
Authorized official ANN LEWIS - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 05/31/2006
Last updated 04/16/2021 - About 5 years ago
Identifiers
SC Medicaid CBP012
SC Medicaid FQC064
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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