Active NPI
Loris Community Hospital District
Doing business as Loris Healthcare System
- Emergency Medical Services (Emergency Medicine) Physician
- Loris, SC
National Provider Identifier
1073688057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician
- License
- HTL033
- Legal business name
- LORIS COMMUNITY HOSPITAL DISTRICT
- Doing business as
- Loris Healthcare System
- Practice address
- 3655 Mitchell St
Box 690001
Loris, SC 29569-9601 - Phone
- (843) 716-7596
- Fax
- (843) 716-7093
- NPI assigned
- Nov 22, 2006
- Last updated
- May 25, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Fred O Todd
- Title
- Senior VP/Cfo
- Phone
- (843) 716-7271
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | HTL033 | SC | Primary |
Addresses
Primary practice location
3655 Mitchell St
Box 690001
Loris, SC 29569-9601
Mailing address
3655 Mitchell St
Box 690001
Loris, SC 29569-9601
Phone (843) 716-7596
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 400649 | Medicaid | SC |
Other names 1
- LORIS HEALTHCARE SYSTEM
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1274745600000",
"number": "1073688057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3655 MITCHELL ST",
"address_2": "BOX 690001",
"city": "LORIS",
"state": "SC",
"postal_code": "295699601",
"telephone_number": "843-716-7596",
"fax_number": "843-716-7093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3655 MITCHELL ST",
"address_2": "BOX 690001",
"city": "LORIS",
"state": "SC",
"postal_code": "295699601",
"telephone_number": "843-716-7596",
"fax_number": "843-716-7093"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LORIS COMMUNITY HOSPITAL DISTRICT",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-22",
"last_updated": "2010-05-25",
"status": "A",
"authorized_official_last_name": "TODD",
"authorized_official_first_name": "FRED",
"authorized_official_middle_name": "O",
"authorized_official_title_or_position": "SENIOR VP/CFO",
"authorized_official_telephone_number": "843-716-7271",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "SC",
"license": "HTL033",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "400649",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "LORIS HEALTHCARE SYSTEM",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Loris, SC
- Denise Logan, MS RD LD
- John C Lohlun, MD
- Loris Adult Day Care, LLC
- Loris Anesthesia and Pain Treatment, PLLC
- Loris Community Hospital District (Loris Extended Care Center)
- Loris Community Hospital District (Seacoast Pulmonology and Critical Care Associates)
- Loris Community Hospital District (Loris Family Health Center)
- Loris Community Hospital District (DBA Southern Medical Associates)
- Loris Community Hospital District (Loris Healthcare System)
- Loris Drug Company LLC (Loris Drug Store)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.