| Organization Name: | LITTLE RIVER MEDICAL CENTER INC |
| NPI Number: | 1053471623 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AVANGELA KAY CRISWELL (BUSINESS OFFICE DIRECTOR) |
| Mailing Address: | 4303 Live Oak Dr Little River |
| State: | SC US |
| Postal Code: | 295669138 |
| Phone Number: | 8436638000 |
| Fax Number: | 8436638154 |
| NPI Enumeration Date: | 12/12/2006 |
| NPI Last Update Date: | 11/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |