Healthcare Provider Details

I. General information

NPI: 1679113526
Provider Name (Legal Business Name): LOW COUNTRY ENDOSCOPY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2020
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 MCBRIDE LANE
SUMMERVILLE SC
29486-7887
US

IV. Provider business mailing address

2001 2ND AVE STE 101
SUMMERVILLE SC
29486-7887
US

V. Phone/Fax

Practice location:
  • Phone: 843-722-8000
  • Fax: 843-266-5125
Mailing address:
  • Phone: 843-722-8000
  • Fax: 843-266-5125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: COLLIN LEMAISTRE
Title or Position: MARKET PRESIDENT
Credential:
Phone: 214-213-0732