Provider Demographics
NPI:1790850865
Name:LOWER FLORENCE COUNTY HOSPITAL
Entity Type:Organization
Organization Name:LOWER FLORENCE COUNTY HOSPITAL
Other - Org Name:LAKE CITY COMMUNITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-374-2036
Mailing Address - Street 1:258 N RON MCNAIR BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:SC
Mailing Address - Zip Code:29560-2462
Mailing Address - Country:US
Mailing Address - Phone:843-374-2036
Mailing Address - Fax:843-374-5111
Practice Address - Street 1:258 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:843-374-2036
Practice Address - Fax:843-374-5111
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOWER FLORENCE COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-22
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHTL897275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC42U066Medicare ID - Type UnspecifiedMEDICARE
SC42U066Medicare Oscar/Certification