BLACK RIVER HEALTHCARE, INC. (NPI# 1992077424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992077424 |
| Entity Type | Organization |
| Organization Name | BLACK RIVER HEALTHCARE, INC. |
| Other Organization Name | BLACK RIVER HEALTHCARE - MANNING MEDICAL |
| Practice Address |
11 W. Hospital St. Manning SC 29102-2925 |
| Mailing Address |
Po Box 578 Manning SC 29102-0578 |
| Practice Telephone | 8034334321 |
| Practice Fax Number | 8034330075 |
| Mailing Telephone | 8034336790 |
| Mailing Fax Number | 8034336796 |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2012-01-30 |
| Authorized Official Name | BARBARA F. BROOKS (C.E.O.) |
| Authorized Official Telephone | 8034336790 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Black River Healthcare - Manning Medical | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699969733 | Black River Healthcare, Inc. | Obstetrics & Gynecology | 500 Thurgood Marshall Boulevard, Suite A, Kingstree, SC 29556 | 2007-08-31 |
| 1275566440 | Black River Healthcare, Inc. | Registered Nurse | 206 East Market Street, Timmonsville, SC 29161 | 2006-07-09 |
| 1508809542 | Black River Healthcare, Inc. | Clinic/Center | 139 Main Street, Olanta, SC 29114 | 2006-06-14 |
| 1497798599 | Black River Healthcare, Inc. | Clinic/Center | 520 Thurgood Marshall Blvd., Suite B, Kingstree, SC 29556 | 2006-06-14 |
| 1376841064 | Black River Healthcare, Inc. | Clinic/Center | 1879 N Westwood Blvd, Poplar Bluff, MO 63901-2833 | 2011-03-04 |
| 1871531574 | Black River Healthcare, Inc. | Pediatrics | 12 W South St, Manning, SC 29102-2925 | 2006-06-03 |
| 1558308965 | Black River Healthcare, Inc. | Nurse Practitioner | 86 N Main St, Greeleyville, SC 29056-9374 | 2006-06-02 |
| Street Address |
11 W. HOSPITAL ST. |
| City | MANNING |
| State | SC |
| Zip Code | 29102-2925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720546138 | Dental Wellness Center of Manning, LLC | Clinic/Center | 1988 Paxille Hwy, Ste 613-01, Manning, SC 29102 | 2019-03-05 |
| 1982148433 | Allison Elaine Saran | Registered Nurse | Mcleod Women's Health, 50 East Hospital Street Suite 4a, Manning, SC 29102 | 2016-12-16 |
| 1629529698 | Clarendon Behavioral Health | Health Maintenance Organization | 14 N. Church Street, Manning, SC 29102 | 2016-10-14 |
| 1396158200 | Monica Ploetzke | Obstetrics & Gynecology | 50 E Hospital St Ste 4a, Manning, SC 29102 | 2014-06-09 |
| 1336567239 | Marian Moody | Registered Nurse | 110 Boyce Street, Dhec Clarendon County Health Dept, Manning, SC 29102 | 2014-03-29 |
| 1700212420 | Southern Lakes Therapy,llc | Physical Therapist | 297 W Boyce St, Manning, SC 29102 | 2013-09-26 |
| 1902190473 | Professional Care of Manning, LLC | In Home Supportive Care | 220 West Boyce St, Manning, SC 29102 | 2011-06-02 |
| 1275789810 | Vital Care Ambulance Service, LLC. | Ambulance | 3662 Greeleyville Hwy, Manning, SC 29102 | 2008-08-14 |
| 1831384015 | Ramona J Howard | Registered Nurse | 10 E. Hospital Street, Hospitalist Department, Manning, SC 29102 | 2007-09-11 |
| 1619098670 | H P Bozard Dds Pa | Dentist | 17 East Hospital Street, Manning, SC 29102 | 2007-04-03 |
| Find all providers in zip 29102 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356458061 | William C. Aldrich | Family Medicine | 1036 Professional Ct, Manning, SC 29102-2827 | 2006-08-25 |
| 1538188495 | Clarendon Memorial Hospital | Family Medicine | 22 Bozard Street, Manning, SC 29102 | 2006-07-19 |
| 1326089590 | Clarendon Memorial Hospital | Family Medicine | 50 Hospital St, Suite 4, Manning, SC 29102 | 2006-06-09 |
| 1003878455 | Edward C. Keith Jr. | Family Medicine | 15 E Hospital St, Manning, SC 29102-3152 | 2006-04-03 |
| 1730166430 | Lisa E Heichberger | Family Medicine | 22 Bozard St, Manning, SC 29102-2935 | 2005-12-23 |
| 1659367241 | Manning Family Healthcare Clinic PC | Family Medicine | 321 Center St, Manning, IA 51455-1020 | 2005-09-20 |
| 1710973391 | Philip L Myer | Family Medicine | 1550 6th Street, Manning, IA 51455-1004 | 2005-09-20 |
| 1558366039 | Robert S Eagerton Jr. | Family Medicine | 200 E Hospital St, Manning, SC 29102-3160 | 2005-06-20 |
| 1790247252 | Ohio Valley Physicians Inc | Family Medicine | 14 N Church St, Manning, SC 29102-3502 | 2019-04-03 |
| 1689194060 | Clarendon Health and Wellness Center | Family Medicine | 107 Sunset Dr, Manning, SC 29102-2904 | 2017-06-26 |
| Find all providers in MANNING | ||||
Please comment or provide details below to improve the information on BLACK RIVER HEALTHCARE, 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.