| Live Oak Medical Center, Pa | |
|
342 W Main St Kingstree SC 29556-3235 | |
| (843) 687-0435 | |
| Not Available |
| Full Name | Live Oak Medical Center, Pa |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 342 W Main St, Kingstree, South Carolina |
| Authorized Official Name and Position | Albert Durant Mims (DIRECTOR) |
| Authorized Official Contact | 8436870435 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Oak Medical Center, Pa 342 W Main St Kingstree SC 29556-3235 Ph: (843) 687-0435 | Live Oak Medical Center, Pa 342 W Main St Kingstree SC 29556-3235 Ph: (843) 687-0435 |
| NPI Number | 1285869222 |
|---|---|
| Provider Enumeration Date | 05/20/2009 |
| Last Update Date | 06/04/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285869222 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 9352 (South Carolina) | Primary |
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