NPI | 1780742825 |
---|---|
Entity Type | Organization |
Authorized Contact | ERNEST JAMES STANLEY WARDLAW CEO 843-335-8291 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2006-12-04 |
Last Update Date | 2023-09-29 |