LITTLE RIVER MEDICAL CENTER, INC. (NPI# 1942524368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942524368 |
| Entity Type | Organization |
| Organization Name | LITTLE RIVER MEDICAL CENTER, INC. |
| Practice Address |
5209 Highway 66 Loris SC 29569-5962 |
| Mailing Address |
287 Highway 90 E Ste 5 Ste#5 Little River SC 29566-7214 |
| Practice Telephone | 8437562181 |
| Practice Fax Number | 8437560522 |
| Mailing Telephone | 8436631013 |
| Mailing Fax Number | 8436631017 |
| Enumeration Date | 2010-03-15 |
| Last Update Date | 2010-03-16 |
| Authorized Official Name | MRS. AVANGELA K CRISWELL (BUSINESS OFFICE DIRECTOR) |
| Authorized Official Telephone | 8436631013 |
| Is Organization Subpart | Y |
| Parent Organization Name | LITTLE RIVER MEDICAL CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 4406 | SC | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | ZA9656 | 05 |
| 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 |
| 1225304546 | Little River Medical Center, Inc. | Counselor | 1411 10th Ave N, Myrtle Beach, SC 29577-5615 | 2012-03-30 |
| 1528333952 | Little River Medical Center, Inc. | Dentist | 504 Church St, Conway, SC 29526-4822 | 2012-03-19 |
| 1437455144 | Little River Medical Center, Inc. | Social Worker | 7726 N Kings Hwy, Myrtle Beach, SC 29572-3041 | 2011-01-28 |
| 1841514262 | Little River Medical Center, Inc. | Dentist | 3001 4th Ave, Conway, SC 29527-5914 | 2010-03-15 |
| 1679897094 | Little River Medical Center, Inc. | Dentist | 620 29th Ave N, Myrtle Beach, SC 29577-3169 | 2010-03-15 |
| 1437473857 | Little River Medical Center, Inc. | Dentist | 1101 Snowhill Dr, Conway, SC 29526-3665 | 2010-03-15 |
| 1851615272 | Little River Medical Center, Inc. | Dentist | 3011 Nichols Hwy, Galivants Ferry, SC 29544-6059 | 2010-03-15 |
| 1770807190 | Little River Medical Center, Inc. | Dentist | 4580 Highway 472, Conway, SC 29526-6340 | 2010-03-15 |
| 1932423357 | Little River Medical Center, Inc. | Dentist | 6555 Highway 134, Conway, SC 29527-5213 | 2010-03-15 |
| 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 |
5209 HIGHWAY 66 |
| City | LORIS |
| State | SC |
| Zip Code | 29569-5962 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427464247 | Denise Logan | Dietitian, Registered | 3811 Walnut St, Loris, SC 29569 | 2014-07-02 |
| 1801231634 | Melissa Ann Miara | Internal Medicine | 3617 Casey St Ste C, Loris, SC 29569 | 2013-05-07 |
| 1356684161 | Gwyn Gordon Mcgutchen | Dentist | 3681 Spivey St., Loris, SC 29569 | 2013-03-29 |
| 1336486174 | Winferd Dale Holt | Dentist | 3980 Main Street, Loris, SC 29569 | 2013-01-14 |
| 1528314325 | Southern Living Emergency Physicians LLC | Physician Assistant | 6988 Mitchell Street, Loris, SC 29569 | 2012-07-30 |
| 1124347604 | Regina F. Holmes | Nurse Practitioner | Agape Senior Primary Care Inc Dba Main Street Physician, 3612 Mitchell Street, Loris, SC 29569 | 2010-05-24 |
| 1801914122 | Dr Gwyn Gordon Mccutchen Inc | Dentist | 3681 Spivey Street, Loris, SC 29569 | 2007-03-26 |
| 1700911203 | Twin States Helping Hands | Home Health | 1620 Hwy 701 N, Loris, SC 29569 | 2007-02-23 |
| 1306922646 | Loris Community Hospital District | Clinic/Center | 3204 Casey St, Loris, SC 29569 | 2006-10-30 |
| 1619074119 | South Carolina Cvs Pharmacy LLC | Pharmacy | 4767 Broad St, Loris, SC 29569 | 2006-09-20 |
| Find all providers in zip 29569 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104272996 | Loris Family Dentistry, LLC | Dentist | 3681 Spivey St, Loris, SC 29569-2838 | 2016-05-11 |
| 1336486174 | Winferd Dale Holt | Dentist | 3980 Main Street, Loris, SC 29569 | 2013-01-14 |
| 1215251632 | Little River Medical Center, Inc. | Dentist | 901 Hwy 9 Business E, Loris, SC 29569-2684 | 2010-03-15 |
| 1225218605 | Little River Medical Center, Inc. | Dentist | 2801 Red Bluff Rd, Loris, SC 29569-6224 | 2007-11-14 |
| 1801914122 | Dr Gwyn Gordon Mccutchen Inc | Dentist | 3681 Spivey Street, Loris, SC 29569 | 2007-03-26 |
| 1013988344 | Edward Wesley Teal Jr. | Dentist | 4004 Bayboro St, Loris, SC 29569-2867 | 2006-01-26 |
| 1750862405 | Daniel Taylor | Dentist | 3681 Spivey St, Loris, SC 29569-2838 | 2018-08-21 |
| 1144483728 | Holly Mangum | Dentist | 4004 Bayboro St, Loris, SC 29569-2867 | 2008-07-03 |
| 1740252758 | John Edward Harvey | Dentist | 4004 Bayboro St, Loris, SC 29569 | 2006-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558057 | Roberto Selonk Buechele | Dentist | 460 Killian Rd Ste 1, Columbia, SC 29203-9742 | 2020-11-02 |
| 1396342762 | Leonard James Cochrane IIi | Dentist | 150 Bee St Apt 706, Charleston, SC 29401-5706 | 2020-10-07 |
| 1134735129 | Kidz Planet Pediatric Dentistry - Sda Pa | Dentist | 960 Ribaut Rd Ste 3, Beaufort, SC 29902-5434 | 2020-09-16 |
| 1265043756 | Steven Mariani Rodriguez | Dentist | 5330 Moseby Street, Columbia, SC 29207 | 2020-08-10 |
| 1336759307 | Elizabeth Blakeney Sitton | Dentist | 3463 Us-21 #101, Fort Mill, SC 29715 | 2020-08-05 |
| 1922624618 | Todays Dental At Lexington LLC | Dentist | 458 Old Cherokee Rd Ste 100, Lexington, SC 29072-6971 | 2020-06-18 |
| 1912522426 | Andrea Ballengee | Dentist | 4405 Highway 17, Murrells Inlet, SC 29576-5097 | 2020-06-10 |
| 1568082493 | Nichole Eckrich | Dentist | 5330 Moseby St., Columbia, SC 29207 | 2020-04-21 |
| 1750919718 | Destination Dental LLC | Dentist | 155 Deacon Tiller Ct Ste 101, Duncan, SC 29334-8880 | 2020-03-27 |
| 1194360024 | Affordable Dentures & Implants - Orangeburg, P.C. | Dentist | 1532 Saint Matthews Rd, Orangeburg, SC 29118-2437 | 2019-11-14 |
| Find all providers with the same taxonomy | ||||
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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.