Provider Demographics
NPI:1326171752
Name:LOWCOUNTRY HEALTHCARE, PA
Entity Type:Organization
Organization Name:LOWCOUNTRY HEALTHCARE, PA
Other - Org Name:MT PLEASANT CENTER FOR ADULT AND SR HEALTHCARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REX
Authorized Official - Middle Name:S
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-388-0106
Mailing Address - Street 1:1230 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3251
Mailing Address - Country:US
Mailing Address - Phone:843-388-0106
Mailing Address - Fax:843-388-0107
Practice Address - Street 1:1230 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3251
Practice Address - Country:US
Practice Address - Phone:843-388-0106
Practice Address - Fax:843-388-0107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23358207R00000X
SC27026207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDD8758OtherMEIDCARE RAILROAD GRP ID
SCGP4254Medicaid
SC1326171752OtherNPI
SCP00257343OtherMEDICARE RAILROAD PROV ID
SCDD8758OtherMEIDCARE RAILROAD GRP ID
SCAA10068307Medicare PIN