| Organization Name: | TOWN OF WAGENER SOUTH CAROLINA |
| NPI Number: | 1336516921 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ARMAND BEAUDRY (OFFICE MANAGER) |
| Mailing Address: | 120 Louie St Wagener |
| State: | SC US |
| Postal Code: | 291649445 |
| Phone Number: | 8035648803 |
| Fax Number: | 8035648804 |
| NPI Enumeration Date: | 08/31/2015 |
| NPI Last Update Date: | 03/15/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | 261QH0100X |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |