| NPI | 1124473228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH BACHICH Director 843-375-3044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: SC IHCP-0263) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2016-04-27 |