| NPI | 1437455144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA R DAVIS CEO 843-663-1013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 183500000X Pharmacist | |
| 207Q00000X Family Medicine | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2014-12-09 |