Healthcare Provider Details
I. General information
NPI: 1386686517
Provider Name (Legal Business Name): MARION COUNTY WOMEN'S CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/12/2006
Last Update Date: 07/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1324 NORTH MAIN STREET
MARION SC
29571-0250
US
IV. Provider business mailing address
1324 NORTH MAIN STREET PO BOX 250
MARION SC
29571-0250
US
V. Phone/Fax
- Phone: 843-423-3800
- Fax: 843-423-3224
- Phone: 843-423-3800
- Fax: 843-423-3224
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM2500X |
| Taxonomy | Medical Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
VALERIE
BURKE
Title or Position: OWNER
Credential: M.D.,F.A.C.O.G.
Phone: 843-423-3800