BLACK RIVER HEALTHCARE, INC. (NPI# 1699969733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1699969733 |
Entity Type | Organization |
Organization Name | BLACK RIVER HEALTHCARE, INC. |
Other Organization Name | KINGSTREE WOMEN'S CENTER |
Practice Address |
500 Thurgood Marshall Boulevard Suite A Kingstree SC 29556 |
Mailing Address |
Po Box 578 Manning SC 29102-0578 |
Practice Telephone | 8433551425 |
Practice Fax Number | 8433551429 |
Mailing Telephone | 8433551425 |
Mailing Fax Number | 8433551429 |
Enumeration Date | 2007-08-31 |
Last Update Date | 2008-12-11 |
Authorized Official Name | MS. BARBARA F. BROOKS (CHIEF EXECUTIVE OFFICER) |
Authorized Official Telephone | 8034336790 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
999 | SC | Allopathic & Osteopathic Physicians |
Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Kingstree Women's Center | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992077424 | Black River Healthcare, Inc. | Nurse Practitioner | 11 W. Hospital St., Manning, SC 29102-2925 | 2012-01-30 |
1275566440 | Black River Healthcare, Inc. | Registered Nurse | 206 East Market Street, Timmonsville, SC 29161 | 2006-07-09 |
1508809542 | Black River Healthcare, Inc. | Clinic/Center | 139 Main Street, Olanta, SC 29114 | 2006-06-14 |
1497798599 | Black River Healthcare, Inc. | Clinic/Center | 520 Thurgood Marshall Blvd., Suite B, Kingstree, SC 29556 | 2006-06-14 |
1376841064 | Black River Healthcare, Inc. | Clinic/Center | 1879 N Westwood Blvd, Poplar Bluff, MO 63901-2833 | 2011-03-04 |
1871531574 | Black River Healthcare, Inc. | Pediatrics | 12 W South St, Manning, SC 29102-2925 | 2006-06-03 |
1558308965 | Black River Healthcare, Inc. | Nurse Practitioner | 86 N Main St, Greeleyville, SC 29056-9374 | 2006-06-02 |
Street Address |
500 THURGOOD MARSHALL BOULEVARD SUITE A |
City | KINGSTREE |
State | SC |
Zip Code | 29556 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689198996 | April Wilson | Home Health Aide | 706 Sandy Bay Rd, Kingstree, SC 29556 | 2017-07-28 |
1588000657 | Jennifer Moore Lamb | Registered Nurse | 500 North Academy St, Building K, Kingstree, SC 29556 | 2013-05-16 |
1619227014 | Hallie Mcnair Dubose | Pharmacist | 120 North Longstreet St, Kingstree, SC 29556 | 2012-09-12 |
1457578486 | Dawkins Medical Transport | Ambulance | 89 Drylog Avenue, Kingstree, SC 29556 | 2007-04-19 |
1306971502 | Vital Aging of Williamsburg County, Inc. | Home Delivered Meals | 501 North Longstreet Street, Kingstree, SC 29556 | 2007-02-21 |
1356489579 | Harry Wells Floyd | General Practice | 500 Thurgood Marshall Blvd, Suite F, Kingstree, SC 29556 | 2007-02-01 |
1306995782 | Joann Conyers Lockhart | Health Educator | 500 Academy Street, Kingstree, SC 29556 | 2007-01-09 |
1497825723 | The Youth Academy Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 237 Lela Harrison Road, Kingstree, SC 29556 | 2006-11-08 |
1427151109 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 120 N Longst St, Kingstree, SC 29556 | 2006-09-07 |
1497798599 | Black River Healthcare, Inc. | Clinic/Center | 520 Thurgood Marshall Blvd., Suite B, Kingstree, SC 29556 | 2006-06-14 |
Find all providers in zip 29556 |
Taxonomy Code | 261QC1500X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Community Health |
Definition to come... |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.