| NPI | 1720332794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROLAND J GARDNER Chief Executive Officer 843-987-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) (Licence: SC FQC098) |
| Additional Taxonomies | 261QC1500X Clinic/Center Community Health (Licence: SC FQC098) |
| 261QD0000X Clinic/Center Dental (Licence: SC 295441) | |
| 261QM1300X Clinic/Center Multi-Specialty (Licence: SC CBP005) | |
| 261QM2500X Clinic/Center Medical Specialty (Licence: SC FQC098) | |
| 261QR0206X Clinic/Center Radiology, Mammography | |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2022-08-09 |