Pee Dee Health Care, PA
Clinic/Center, Rural Health in Olanta, SC. Organization (NPI-2).
NPI number1003043845
StatusActive
Last updated in NPPESJul 1, 2009
Details
- NPI
- 1003043845
- Entity type
- Organization (NPI-2)
- Legal business name
- Pee Dee Health Care, PA
- Organization subpart
- No
- Enumeration date
- Jun 19, 2009
- Last updated
- Jul 1, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR1300X | Clinic/Center, Rural Health | 13928 | SC | Yes |
Other names
- Olanta Family Care (Doing Business As)
Practice location
211 South Jones RdOlanta, SC 29114
Phone 843-396-9723 · Fax 843-396-9735
Mailing address
3400 West AveColumbia, SC 29203-6901
Phone 803-254-3676 · Fax 803-254-3678
Authorized official
Tony R Megna
Ceo
8032543676
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