Provider Demographics
NPI:1619534112
Name:MCLEOD LORIS SEACOAST HOSPITAL
Entity Type:Organization
Organization Name:MCLEOD LORIS SEACOAST HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP AND ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:VEHIGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-390-8100
Mailing Address - Street 1:4000 HWY 9 EAST
Mailing Address - Street 2:
Mailing Address - City:LITTLE RIVER
Mailing Address - State:SC
Mailing Address - Zip Code:29566
Mailing Address - Country:US
Mailing Address - Phone:843-390-8373
Mailing Address - Fax:843-366-3108
Practice Address - Street 1:4000 HWY 9 EAST
Practice Address - Street 2:OUTPATIENT PHARMACY
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566
Practice Address - Country:US
Practice Address - Phone:843-366-3107
Practice Address - Fax:843-366-3108
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCLEOD LORIS SEACOAST HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy