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LITTLE RIVER MEDICAL CENTER INC. NPI 1669535225


NPI Information

NPI: 1669535225
Provider Name: LITTLE RIVER MEDICAL CENTER, INC.
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1075 MR. JOE WHITE AVE
UNIT 101
MYRTLE BEACH, SC
ZIP 29577
Phone: (843) 839-2049
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LITTLE RIVER MEDICAL CENTER, INC. is a family medicine in Myrtle Beach, SC. The provider is 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. LITTLE RIVER MEDICAL CENTER, INC. NPI is 1669535225. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1075 MR. JOE WHITE AVE
UNIT 101
MYRTLE BEACH, SC
ZIP 29577-658
Phone: (843) 839-2049
Fax: (843) 839-1857

The provider's authorized official is Avangela Kay Criswell .
The authorized official title is Business Office Director and has the following contact phone number (843) 663-1013.

The enumeration date for this NPI number is 12/18/2006 and was last updated on 6/21/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YP2500XCounselorProfessionalSOUTH CAROLINANo
21041C0700XSocial WorkerClinicalSOUTH CAROLINANo
3261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)No
4363LF0000XNurse PractitionerFamilySOUTH CAROLINANo
5207Q00000XFamily MedicineSOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11879MEDICARE PIN
2FQC066MEDICAIDSOUTH CAROLINA
3421890MEDICARE OSCAR/CERTIFICATIONSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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