LITTLE RIVER MEDICAL CENTER, INC (NPI# 1346638483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346638483 |
| Entity Type | Organization |
| Organization Name | LITTLE RIVER MEDICAL CENTER, INC |
| Practice Address |
4220 Carolina Exchange Blvd Myrtle Beach SC 29579 |
| Mailing Address |
Po Box 547 Little River SC 29566-0547 |
| Practice Telephone | 8436638000 |
| Practice Fax Number | 8436638117 |
| Mailing Telephone | 8436638000 |
| Mailing Fax Number | 8436638117 |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2014-12-23 |
| Authorized Official Name | PAMELA R DAVIS (CEO) |
| Authorized Official Telephone | 8436638001 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LITTLE RIVER MEDICAL CENTER, INC. | 451 W Locke St, Ashdown, AR 71822-3325 |
| Street Address |
4220 CAROLINA EXCHANGE BLVD |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29579 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598323198 | P & E Company | Counselor | 4105 Carolina Commercial Dr. Unit #2, Myrtle Beach, SC 29579 | 2019-05-30 |
| 1528624632 | Matthew Meehan | Nurse Practitioner | 4016 River Oaks Dr # 6511, Myrtle Beach, SC 29579 | 2019-05-14 |
| 1427518265 | Brian Donovan Doherty | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center 809 82nd Parkway, Gme Office, Myrtle Beach, SC 29579 | 2019-03-20 |
| 1508347931 | South Carolina Cvs Pharmacy LLC | Pharmacy | 578 International Dr, Myrtle Beach, SC 29579 | 2018-08-23 |
| 1497256176 | Orthosc LLC | Orthopaedic Surgery | 185 Fresh Dr Ste B, Myrtle Beach, SC 29579 | 2018-02-27 |
| 1740708981 | Dental Professional of South Carolina, P.C. | Dentist | 568 International Dr, Myrtle Beach, SC 29579 | 2017-09-08 |
| 1093232480 | Johnathan T Steppe | Dentist | 568 International Drive, Myrtle Beach, SC 29579 | 2017-08-25 |
| 1154726818 | Mina Gaid | Pharmacist | 1303 38th Avenue North, Myrtle Beach, SC 29579 | 2014-10-23 |
| 1528471364 | Paola Goyeneche | Counselor | 5015 Carolina Forest Blvd, Myrtle Beach, SC 29579 | 2014-06-10 |
| 1699191262 | Tiffany Mahaffey | Nurse Practitioner | 1101 Brightwater Drive, Agape Physicians Care, Myrtle Beach, SC 29579 | 2014-03-06 |
| Find all providers in zip 29579 | ||||
| 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 |
|---|---|---|---|---|
| 1932457751 | Little River Medical Center, Inc. | Clinic/Center | 700 Augusta Plantation Drive, Myrtle Beach, SC 29579-6713 | 2012-08-28 |
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| 1982248852 | Regenesis Organization Community Health Center | Clinic/Center | 115 Thomas St Ste B, Union, SC 29379-2147 | 2019-11-04 |
| 1720636012 | Genesis Health Care, Inc | Clinic/Center | 115 Exchange St, Darlington, SC 29532-3203 | 2019-08-29 |
| 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 |
| 1215410667 | Low Country Health Care System | Clinic/Center | 19340 Solomon Blatt Ave N, Blackville, SC 29817-2304 | 2018-09-12 |
| 1922584481 | Sandhills Medical Foundation, Inc. | Clinic/Center | 290 Market Street, Ruby, SC 29741 | 2018-07-17 |
| Find all providers with the same taxonomy | ||||
| City | MYRTLE BEACH |
| Zip Code | 29579 |
Please comment or provide details below to improve the information on LITTLE RIVER MEDICAL CENTER, INC.
| 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.