Provider Demographics
NPI:1316583222
Name:DILLON COUNTY FREE MEDICAL CLINIC
Entity Type:Organization
Organization Name:DILLON COUNTY FREE MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-774-4241
Mailing Address - Street 1:310 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:SC
Mailing Address - Zip Code:29536-2948
Mailing Address - Country:US
Mailing Address - Phone:843-774-4241
Mailing Address - Fax:843-774-4243
Practice Address - Street 1:310 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:SC
Practice Address - Zip Code:29536-2948
Practice Address - Country:US
Practice Address - Phone:843-774-4241
Practice Address - Fax:843-774-4243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable