Provider Demographics
NPI:1437256757
Name:LOWER FLORENCE COUNTY HOSPITAL
Entity Type:Organization
Organization Name:LOWER FLORENCE COUNTY HOSPITAL
Other - Org Name:PEE DEE FAMILY PRACTICE - LAKE CITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-374-6437
Mailing Address - Street 1:PO BOX 1479
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:SC
Mailing Address - Zip Code:29560-1479
Mailing Address - Country:US
Mailing Address - Phone:843-374-2036
Mailing Address - Fax:843-374-3019
Practice Address - Street 1:276 N RON MCNAIR BLVD
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:SC
Practice Address - Zip Code:29560-2462
Practice Address - Country:US
Practice Address - Phone:843-394-5471
Practice Address - Fax:843-394-5459
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOWER FLORENCE COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-20
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCRHC146261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC423430Medicare PIN
SC423430Medicare Oscar/Certification
SC8305Medicare PIN