LITTLE RIVER MEDICAL CENTER, INC.; NPI #1669535225

Contact Information

LITTLE RIVER MEDICAL CENTER, INC.

1075 MR. JOE WHITE AVE
UNIT 101
MYRTLE BEACH, SC 29577-5658

Phone: 843-839-2049
Fax: 843-839-1857
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
Professional	101YP2500X

Indicates primary specialty

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

NPI Number 1669535225

LBN Legal business name LITTLE RIVER MEDICAL CENTER, INC.

Authorized official AVANGELA CRISWELL - (BUSINESS OFFICE DIRECTOR)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 12/18/2006

Last updated 08/02/2024 - More than a year ago

Identifiers

Medicaid

FQC066

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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LITTLE RIVER MEDICAL CENTER, INC.

Contact Information

Specialty

Federally Qualified Health Center (FQHC)

Clinical

Family

Family Medicine

Professional

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

Reviews for LITTLE RIVER MEDICAL CENTER, INC.