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General NPI Number Information
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NPI Number | 1821155904
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Entity Type | Organization
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Legal Business Name | SUMTER FAMILY HEALTH CENTER
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 09/28/2007
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Provider Practice Location Address
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Address Line | 1278 N LAFAYETTE DR
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City | SUMTER
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State | SC
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Zip | 29150-2964
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Country | US
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Telephone | 803-774-4500
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Fax | 803-774-4627
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Provider Business Mailing Address
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Address Line | 1278 N LAFAYETTE DR
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City | SUMTER
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State | SC
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Zip | 29150-2964
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Country | US
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Telephone | 803-774-4500
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Fax | 803-774-4627
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | MRS. THERESA W HARDIN
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Credential | FNP
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Telephone | 803-774-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | APN 3096
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License Number State | SC
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