Organization Name: | PEE DEE HEALTH CARE, PA |
NPI Number: | 1003043845 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TONY R MEGNA (CEO) |
Mailing Address: | 211 South Jones Rd Olanta |
State: | SC US |
Postal Code: | 29114 |
Phone Number: | 8433969723 |
Fax Number: | 8433969735 |
NPI Enumeration Date: | 06/19/2009 |
NPI Last Update Date: | 07/01/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | 13928 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |