LOW COUNTRY HEALTH CARE SYSTEM, INC. (NPI# 1235225608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235225608 |
| Entity Type | Organization |
| Organization Name | LOW COUNTRY HEALTH CARE SYSTEM, INC. |
| Other Organization Name | FAMILY MEDICAL CENTER OF BLACKVILLE |
| Practice Address |
130 Baker Street Blackville SC 29817 |
| Mailing Address |
86 Wren St Barnwell SC 29812-1529 |
| Practice Telephone | 8032841045 |
| Practice Fax Number | 8032843094 |
| Mailing Telephone | 8032595762 |
| Mailing Fax Number | 8032593250 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2018-08-23 |
| Authorized Official Name | ASHLEY L BARNES (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 8036322533 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
========= | SC | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | FQC077 | 05 | |
| SC | MEDICARE PART B PTAN | F785 | 01 |
| Other Name | Type Code |
|---|---|
| Family Medical Center of Blackville | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194288571 | Low Country Health Care System, Inc. | Clinic/Center | 209 Abbeville Ave Nw, Aiken, SC 29801-3923 | 2019-04-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LOW COUNTRY HEALTH CARE SYSTEM, INC. | 333 Revolutionary Trail, Fairfax, SC 29827-7109 |
| Street Address |
130 BAKER STREET |
| City | BLACKVILLE |
| State | SC |
| Zip Code | 29817 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194278879 | Kimberly Spires | Nurse Practitioner | 130 Baker Street, Blackville, SC 29817-2304 | 2016-07-28 |
| 1992034946 | Kerin A Mccormack | Family Medicine | 130 Baker Street, Blackville, SC 29817-2304 | 2009-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699808006 | Carolina Rural Practice Management, Inc. | Clinic/Center | 22 Gardener Rd, Box 247, Blackville, SC 29817-0247 | 2007-03-14 |
| 1215410667 | Low Country Health Care System | Clinic/Center | 19340 Solomon Blatt Ave N, Blackville, SC 29817-2304 | 2018-09-12 |
| 1821186461 | Blackville Health Investors | Pharmacy | 19354 Solomon Blatt Ave N, Blackville, SC 29817-2304 | 2006-10-10 |
| 1427393024 | Blackville Health Investors | Pharmacy | 19354 Solomon Blatt Ave N, Blackville, SC 29817-2304 | 2012-12-07 |
| 1932444676 | Blackville Health Investors Inc | Durable Medical Equipment & Medical Supplies | 19354 Solomon Blatt Ave N, Blackville, SC 29817-2304 | 2012-12-06 |
| 1659625846 | Rebecca Barr Copeland | Pharmacist | 19354 Solomon Blatt Ave N, Blackville, SC 29817-2304 | 2012-11-09 |
| 1639256605 | Daniels Pharmacy # 3 Inc | Durable Medical Equipment & Medical Supplies | 19354 Solomon Blatt Ave N, Blackville, SC 29817-2304 | 2006-11-01 |
| 1477505337 | Barnwell School District 19 | Local Education Agency (LEA) | 297 Pascallas St, Blackville, SC 29817-2355 | 2006-05-17 |
| 1720603202 | Amy Nicole Ellis | Nurse Practitioner | 130 Baker St N, Blackville, SC 29817-2426 | 2020-06-10 |
| 1578922746 | Shawnta Harrison | Case Manager/Care Coordinator | 337 Baker St N, Blackville, SC 29817-2431 | 2016-02-17 |
| Find all providers in zip 29817 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215410667 | Low Country Health Care System | Clinic/Center | 19340 Solomon Blatt Ave N, Blackville, SC 29817-2304 | 2018-09-12 |
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|---|---|---|---|---|
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| 1063079549 | Health Care Partners of South Carolina, Inc. | Clinic/Center | 243 Singleton Ridge Rd, Units E&f, Conway, SC 29526-8391 | 2019-05-21 |
| 1043775703 | Rural Health Services Inc | Clinic/Center | 4200 Whiskey Rd, Aiken, SC 29803-8534 | 2019-02-07 |
| 1295202356 | Eau Claire Cooperative Health Center Inc. | Clinic/Center | 2600 Wheat St, Columbia, SC 29205-2315 | 2018-10-26 |
| 1922584481 | Sandhills Medical Foundation, Inc. | Clinic/Center | 290 Market Street, Ruby, SC 29741 | 2018-07-17 |
| 1518454818 | Fetter Health Care Network, Inc. | Clinic/Center | 130 Varnfield Dr Ste 100, Summerville, SC 29483-7317 | 2018-04-23 |
| Find all providers with the same taxonomy | ||||
| City | BLACKVILLE |
| Zip Code | 29817 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.