CARESOUTH CAROLINA, INC.; NPI #1780627943

Contact Information

CARESOUTH CAROLINA, INC.

103 KEMPER STREET
LAKE VIEW, SC 29563

Phone: 843-759-2189
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Federally Qualified Health Center (FQHC)	261QF0400X	B4[14]	Federally Qualified Health Center

Indicates primary specialty

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NPI Profile & details for CARESOUTH CAROLINA, INC.

NPI # 1780627943

LBN Legal business name CARESOUTH CAROLINA, INC.

Authorized official ANN LEWIS - (CEO)

Entity Organization

Organization subpart ¹ No

Enumeration date 06/14/2006

Last updated 09/04/2007 - About 19 years ago

Identifiers

SC	Medicaid	CBP013
SC	Medicaid	FQC003

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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