| Organization Name: | PEE DEE HEALTHCARE PA |
| NPI Number: | 1518064229 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TONY R MEGNA (CEO) |
| Mailing Address: | 211 South Jones Road Olanta |
| State: | SC US |
| Postal Code: | 29114 |
| Phone Number: | 8433969730 |
| Fax Number: | 8433969735 |
| NPI Enumeration Date: | 09/17/2006 |
| NPI Last Update Date: | 03/05/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |