Lake City Family Medicine LLC
Clinic/Center, Primary Care in Lake City, SC. Organization (NPI-2).
NPI number1396969002
StatusActive
Last updated in NPPESMar 16, 2009
Details
- NPI
- 1396969002
- Entity type
- Organization (NPI-2)
- Legal business name
- Lake City Family Medicine LLC
- Organization subpart
- No
- Enumeration date
- Apr 12, 2007
- Last updated
- Mar 16, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | SC | Yes |
| 261QR1300X | Clinic/Center, Rural Health | 17100 | SC |
Practice location
901 N. Matthews Rd.Lake City, SC 29560
Phone 843-374-8380
Mailing address
901 N. Matthews Rd.Lake City, SC 29560
Phone 843-374-8380
Authorized official
Morris Edward Brown
Owner
8433748380
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