Provider Demographics
NPI:1710159330
Name:SOUTH OFFICE OF RURAL HEALTH
Entity Type:Organization
Organization Name:SOUTH OFFICE OF RURAL HEALTH
Other - Org Name:LOW COUNTRY HEALTHY START
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINA
Authorized Official - Middle Name:BERRY
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:803-793-6000
Mailing Address - Street 1:4899 CAROLINA HWY
Mailing Address - Street 2:
Mailing Address - City:DENMARK
Mailing Address - State:SC
Mailing Address - Zip Code:29042-1675
Mailing Address - Country:US
Mailing Address - Phone:803-793-6000
Mailing Address - Fax:803-793-6192
Practice Address - Street 1:4899 CAROLINA HWY
Practice Address - Street 2:
Practice Address - City:DENMARK
Practice Address - State:SC
Practice Address - Zip Code:29042-1675
Practice Address - Country:US
Practice Address - Phone:803-793-6000
Practice Address - Fax:803-793-6192
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTH CAROLINA OFFICE OF RURAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare