Organization · Type 2 NPI
Black River Healthcare, Inc.
Community Health Clinic/Center · Kingstree, SC
NPI number
1699969733
Active
Practice location
500 Thurgood Marshall Boulevard, Suite A
Kingstree, SC 29556
Fax (843) 355-1429
Mailing address
PO Box 578
Manning, SC 29102-0578
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Obstetrics Physician | 207VX0000X | 999 (SC) |
| Community Health Clinic/Center Primary | 261QC1500X | None listed |
Community Health Clinic/Center: Definition to come...
About NPI 1699969733
Black River Healthcare, Inc.'s National Provider Identifier is 1699969733, issued on Aug 31, 2007. The primary taxonomy on file is Community Health Clinic/Center (261QC1500X), and the practice location is in Kingstree, SC. The record was last updated on Dec 11, 2008.