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General NPI Number Information
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NPI Number | 1104995372
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Entity Type | Organization
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Legal Business Name | GEORGETOWN PHYSICIAN ASSOCIATES, LLC
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 05/01/2020
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Provider Practice Location Address
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Address Line | 701 S MORGAN AVE
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City | ANDREWS
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State | SC
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Zip | 29510
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Country | US
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Telephone | 843-264-5253
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Fax | 843-264-5970
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Provider Business Mailing Address
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Address Line | PO BOX 421718
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City | GEORGETOWN
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State | SC
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Zip | 29442-4203
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Country | US
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Telephone | 843-520-8330
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Fax | 843-652-8422
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Authorized Official
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Title or Position | EVP & CFO
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Name | ELIZABETH SUTHERLAND WARD
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Credential |
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Telephone | 843-527-7102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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