Live Oak Medical Center, Pa

LBN: Live Oak Medical Center, Pa
Live Oak Medical Center, Pa is an health care organization with primary practice located at 148 Sauls St. , Lake City SC 29560. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Live Oak Medical Center, Pa can be contacted via phone (843) 687-0435, or through Mims, Albert Durant via phone (843) 374-3621.

Contact Information

Primary practice address
148 Sauls St. Lake City SC 29560
Phone: (843) 687-0435
Fax: (843) 374-3624
Website:
Map and Directions
Authorized official contact:
Name: Mims, Albert Durant Doctor of Medicine (MD)
Phone: (843) 374-3621

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 9352 South Carolina

Profile Details

NPI number 1659506699
LBN Legal business name Live Oak Medical Center, Pa
DBA Doing business as
Authorized official Mims, Albert Durant Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 20th, 2009
Last updated Jan 20th, 2010 - about 16 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 1659506699 NPPES
South Carolina MEDICAID GP5322

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