| NPI | 1285869222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT DURANT MIMS Director 843-687-0435 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health (Licence: SC 9352) |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2009-06-04 |