Provider Demographics
NPI:1902205487
Name:SC HEALTHCARE INVESTMENTS LLC
Entity Type:Organization
Organization Name:SC HEALTHCARE INVESTMENTS LLC
Other - Org Name:BLACKVILLE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:T
Authorized Official - Last Name:VALLIANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-259-1000
Mailing Address - Street 1:914 REYNOLDS RD
Mailing Address - Street 2:
Mailing Address - City:BARNWELL
Mailing Address - State:SC
Mailing Address - Zip Code:29812-6358
Mailing Address - Country:US
Mailing Address - Phone:803-259-4041
Mailing Address - Fax:803-259-3974
Practice Address - Street 1:914 REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:BARNWELL
Practice Address - State:SC
Practice Address - Zip Code:29812-6358
Practice Address - Country:US
Practice Address - Phone:803-259-4041
Practice Address - Fax:803-259-3974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHTL0485261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care