| Little River Medical Center, Inc. | |
|
164 Waccamaw Medical Park Dr Conway SC 29526-8903 | |
| (843) 347-4888 | |
| (843) 663-1017 |
| Full Name | Little River Medical Center, Inc. |
|---|---|
| Speciality | Counselor - Professional |
| Location | 164 Waccamaw Medical Park Dr, Conway, South Carolina |
| Authorized Official Name and Position | Avangela K Criswell (BUSINESS OFFICE DIRECTOR) |
| Authorized Official Contact | 8436638017 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Little River Medical Center, Inc. Po Box 547 Little River SC 29566-0547 Ph: (843) 663-8000 | Little River Medical Center, Inc. 164 Waccamaw Medical Park Dr Conway SC 29526-8903 Ph: (843) 347-4888 |
| NPI Number | 1073888400 |
|---|---|
| Provider Enumeration Date | 03/19/2012 |
| Last Update Date | 03/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073888400 | NPI | - | NPPES |
| FQC024 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 3657 (South Carolina) | Primary |
| 104100000X | Social Worker | 7136 (South Carolina) | Secondary |
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