Carolinas Medical Alliance, Inc

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

CAROLINAS MEDICAL ALLIANCE, INC

Doing business as

Lake City Medical Clinic

Practice address

101 John St
Lake City, SC 29560-2411

Phone

(843) 394-2031

Fax

(843) 394-7411

NPI assigned

Apr 30, 2007

Last updated

Jan 2, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sophia L Arwood

Title

Director

Phone

(615) 628-6038

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lake City Medical Clinic Doing business as

Locations

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388620800000",
    "number": "1215157334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 JOHN ST",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602411",
            "telephone_number": "843-394-2031",
            "fax_number": "843-394-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 JOHN ST",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602411",
            "telephone_number": "843-394-2031",
            "fax_number": "843-394-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS MEDICAL ALLIANCE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-30",
        "last_updated": "2014-01-02",
        "status": "A",
        "authorized_official_last_name": "ARWOOD",
        "authorized_official_first_name": "SOPHIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-628-6038"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC107",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake City Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Rural Health Clinic/Center in Lake City, SC
• Providers in Lake City, 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 2, 2014; 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.