Loris Community Hospital District

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

LORIS COMMUNITY HOSPITAL DISTRICT

Doing business as

Mt Olive Family Health Center

Practice address

5260 Hwy 9
Green Sea, SC 29545

Phone

(843) 392-9222

Fax

(843) 392-1445

NPI assigned

Oct 18, 2006

Organization subpart

No

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 Vice President/Cfo

Phone

(843) 716-7520

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MT OLIVE FAMILY HEALTH CENTER Doing business as

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1194806604",
    "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": "29569",
            "telephone_number": "843-392-9222",
            "fax_number": "843-392-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5260 HWY 9",
            "city": "GREEN SEA",
            "state": "SC",
            "postal_code": "29545",
            "telephone_number": "843-392-9222",
            "fax_number": "843-392-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORIS COMMUNITY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "TODD",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT/CFO",
        "authorized_official_telephone_number": "843-716-7520",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC502",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MT OLIVE FAMILY HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Allison Bird, ATC
• Kathryn M Campman, ATC, SCAT
• Peyton Fogarty
• Jodi Lennon, BCABA
• Little River Medical Center, Inc.
• McLeod Physician Associates II (Family Health Center - Mt. Olive)
• Pee-Wee's Behavioral Services LLC
• Gianna Lee Simmons
• Laquosha Smith, LPC, NCC

• Rural Health Clinic/Center in Green Sea, SC
• Providers in Green Sea, SC by specialty
• Rural Health Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.