Organization · Type 2 NPI

State of South Carolina

Public Health or Welfare Agency · Conway, SC

NPI number 1659457778 Active

Practice location

1931 Industrial Park Road
Conway, SC 29526

Fax (843) 915-6505

Mailing address

400 Otarre Pkwy
Cayce, SC 29033-3751

Specialties and licenses

TaxonomyCodeLicense
Public Health or Welfare Agency Primary 251K00000XNone listed

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About NPI 1659457778

State of South Carolina's National Provider Identifier is 1659457778, issued on Oct 31, 2006. The primary taxonomy on file is Public Health or Welfare Agency (251K00000X), and the practice location is in Conway, SC. The record was last updated on Oct 7, 2025.