NPIMap

Organization Active NPI

Lower Florence County Hospital

Doing business as Palmetto Primary Care

  • Family Medicine Physician
  • Lake City, SC
National Provider Identifier
1063613099
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
GP3704 Issued in SC
Legal business name
LOWER FLORENCE COUNTY HOSPITAL
Doing business as
Palmetto Primary Care
Practice address
330 Mercy St
Lake City, SC 29560-2332
Phone
(843) 374-9355
Fax
(843) 374-9358
NPI assigned
May 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Mary C Duke
Title
Director of PFS
Phone
(843) 374-6431

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X GP3704 SC Primary

Addresses

Primary practice location

330 Mercy St
Lake City, SC 29560-2332

Mailing address

258 N Ron McNair Blvd
Lake City, SC 29560-2462
Phone (843) 374-2036

Other identifiers 1

IdentifierTypeStateIssuer
GP3704MedicaidSC

Other names 1

  • PALMETTO PRIMARY CARE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lower Florence County Hosp7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

330 Mercy St
Lake City, SC 29560
Phone (843) 374-2036

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063613099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 N RON MCNAIR BLVD",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602462",
            "telephone_number": "843-374-2036",
            "fax_number": "843-374-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MERCY ST",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602332",
            "telephone_number": "843-374-9355",
            "fax_number": "843-374-9358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWER FLORENCE COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DUKE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR OF PFS",
        "authorized_official_telephone_number": "843-374-6431",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "GP3704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3704",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PALMETTO PRIMARY CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake City, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.