=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063876084
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LOW COUNTRY HEALTH CARE SYSTEM
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/06/2016
-----------------------------------------------------
Last Update Date | 03/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 WREN ST
-----------------------------------------------------
City | BARNWELL
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29812-1533
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-591-7891
-----------------------------------------------------
Fax | 803-259-0539
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 86 WREN ST
-----------------------------------------------------
City | BARNWELL
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29812-1529
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-259-5762
-----------------------------------------------------
Fax | 803-259-3050
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | ASHLEY BARNES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 803-632-2533
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0002X
-----------------------------------------------------
Taxonomy Name | Clinic Pharmacy
-----------------------------------------------------
License Number | 16450
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------