NPI | 1629021076 |
---|---|
Entity Type | Organization |
Authorized Contact | PAMELA R DAVIS CEO 843-663-8001 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 207Q00000X Family Medicine |
1041C0700X Social Worker, Clinical | |
163WD0400X Registered Nurse, Diabetes Educator | |
122300000X Dentist | |
183500000X Pharmacist | |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2006-05-18 |
Last Update Date | 2014-05-21 |