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Contact Information

LITTLE RIVER MEDICAL CENTER INC
4303 LIVE OAK DR
LITTLE RIVER, SC29566-9138
 Phone: 843-663-8000
 Fax: 843-663-8154
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
 

Federally Qualified Health Center (FQHC)

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

NPI Profile & details for LITTLE RIVER MEDICAL CENTER INC

NPI # 1053471623
LBN Legal business name LITTLE RIVER MEDICAL CENTER INC
Authorized official AVANGELA CRISWELL - (BUSINESS OFFICE DIRECTOR)
Entity Organization
Organization subpart 1 Yes
Enumeration date 12/12/2006
Last updated 11/02/2012 - About 14 years ago
Identifiers
SC License # 4406
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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