Healthcare Provider Details

I. General information

NPI: 1235330267
Provider Name (Legal Business Name): LOWER FLORENCE COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 05/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

276 N RON MCNAIR BLVD
LAKE CITY SC
29560-2462
US

IV. Provider business mailing address

276 N RON MCNAIR BLVD
LAKE CITY SC
29560-2462
US

V. Phone/Fax

Practice location:
  • Phone: 843-374-5471
  • Fax: 843-374-5315
Mailing address:
  • Phone: 843-374-5471
  • Fax: 843-374-5315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberGP1912
License Number StateSC

VIII. Authorized Official

Name: MS. MARY C DUKE
Title or Position: DIRECTOR OF PFS
Credential:
Phone: 843-374-6431