Organization Name: | CHESTERFIELD MARLBORO LP |
NPI Number: | 1407978190 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEBBIE T BREWER (DIRECTOR) |
Mailing Address: | 1040 Marlboro Way Suite 1 Bennettsville |
State: | SC US |
Postal Code: | 295122494 |
Phone Number: | 8434795890 |
Fax Number: | 8434795893 |
NPI Enumeration Date: | 04/04/2007 |
NPI Last Update Date: | 09/28/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |