Organization Name: | CARESOUTH CAROLINA INC |
NPI Number: | 1275812216 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANN M LEWIS (CEO) |
Mailing Address: | 106 Hospital Sq Bishopville |
State: | SC US |
Postal Code: | 290107081 |
Phone Number: | 8034845943 |
Fax Number: | 8034846975 |
NPI Enumeration Date: | 08/09/2011 |
NPI Last Update Date: | 07/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |