Little River Medical Center, Inc.

LBN: Little River Medical Center, Inc.
Little River Medical Center, Inc. is an health care organization with primary practice located at 1075 Mr. Joe White Ave Unit 101, Myrtle Beach SC 29577-5658. The organization recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical, Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), Physician Assistants & Advanced Practice Nursing Providers / Family. Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty. Little River Medical Center, Inc. can be contacted via phone (843) 839-2049, or through Criswell, Avangela Kay via phone (843) 663-1013.

Contact Information

Primary practice address
1075 Mr. Joe White Ave Unit 101 Myrtle Beach SC 29577-5658
Phone: (843) 839-2049
Fax: (843) 839-1857
Website:
Map and Directions
Authorized official contact:
Name: Criswell, Avangela Kay
Phone: (843) 663-1013

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X South Carolina
Behavioral Health & Social Service Providers / Clinical 1041C0700X South Carolina
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X South Carolina
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X South Carolina

Profile Details

NPI number 1669535225
LBN Legal business name Little River Medical Center, Inc.
DBA Doing business as
Authorized official Criswell, Avangela Kay
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 18th, 2006
Last updated Dec 9th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669535225 NPPES
South Carolina MEDICAID FQC066

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