| Little River Medical Center, Inc. | |
|
4950 Socastee Blvd Myrtle Beach SC 29588-7239 | |
| (843) 293-7800 | |
| (843) 293-6331 |
| Full Name | Little River Medical Center, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 4950 Socastee Blvd, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Avangela Kay Criswell (BUSINESS OFFICE DIRECTOR) |
| Authorized Official Contact | 8436631013 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Little River Medical Center, Inc. Po Box 547 Suite 3 Little River SC 29566-0547 Ph: (843) 663-1013 | Little River Medical Center, Inc. 4950 Socastee Blvd Myrtle Beach SC 29588-7239 Ph: (843) 293-7800 |
| NPI Number | 1487835799 |
|---|---|
| Provider Enumeration Date | 11/15/2007 |
| Last Update Date | 03/29/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487835799 | NPI | - | NPPES |
| FQCO24 | Medicaid | SC | |
| ZA9656 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4406 (South Carolina) | Primary |
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