| NPI | 1114066883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAURANG C SHAH Medical Director 803-329-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health (Licence: SC 22018) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-04-02 |