Healthcare Provider Details

I. General information

NPI: 1790850865
Provider Name (Legal Business Name): LOWER FLORENCE COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 02/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 843-374-2036
  • Fax: 843-374-5111
Mailing address:
  • Phone: 843-374-2036
  • Fax: 843-374-5111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License NumberHTL897
License Number StateSC

VIII. Authorized Official

Name: MS. MARY DUKE
Title or Position: DIRECTOR
Credential:
Phone: 843-374-2036