NPIMap

Organization Active NPI

Family Health Centers, Inc

Doing business as Family Health Centers at Holly Hill

  • Federally Qualified Health Center (FQHC)
  • Holly Hill, SC
National Provider Identifier
1609279744
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FAMILY HEALTH CENTERS, INC
Doing business as
Family Health Centers at Holly Hill
Practice address
922 Holly St
Holly Hill, SC 29059-2762
Phone
(803) 531-6900
NPI assigned
Oct 3, 2014
Last updated
May 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Authorized official

Name
Dr. Ernest Stan Wardlaw
Title
Ceo
Phone
(803) 531-6900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

922 Holly St
Holly Hill, SC 29059-2762

Mailing address

922 Holly St
Holly Hill, SC 29059-2762
Phone (803) 759-3069

Other names 1

  • Family Health Centers at Holly Hill Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031112000393 SC Part B Supplier - Clinic/Group Practice 2860305075 Receives reassigned benefits from 25 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Swansea, SC; St Matthews, SC; Orangeburg, SC; Denmark, SC; Holly Hill, SC
O20150605001247 SC Part A Provider - Federally Qualified Health Center (FQHC) 2860305075 Practice locations: Holly Hill, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609279744. Details of each certification follow.

Federally qualified health center certification: CCN 421026

Legal name
FAMILY HEALTH CENTERS, INC.
Doing business as
FAMILY HEALTH CENTERS AT HOLLY HILL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 9, 2015
Last certification
Jul 9, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 22, 1970 in SC
Enrollment address
922 Holly St
Holly Hill, SC 29059-2762

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D0248667Family Health Center of Holly Hill922 Holly Street, Holly Hill, SC 29059Certificate of waiverAug 16, 2027

National Provider Directory

National Provider Directory
Tax ID family
Family Health Center Pharmacy29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

Locations

1241 Solomon Blatt Blvd
Denmark, SC 29042
Phone (803) 793-4282

45 Green St
Denmark, SC 29042
Phone (803) 793-3383

655 Laurel St
Orangeburg, SC 29115
Phone (803) 531-6900

132 Saints Ave
St Matthews, SC 29135
Phone (803) 655-2750

150 Saints Ave
St Matthews, SC 29135
Phone (803) 874-3071

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Dondre Wilson Individual Operational/Managerial ControlCfo Jan 1, 2024

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1412294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778544000000",
    "number": "1609279744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 HOLLY ST",
            "city": "HOLLY HILL",
            "state": "SC",
            "postal_code": "290592762",
            "telephone_number": "803-759-3069",
            "fax_number": "803-496-7928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 HOLLY ST",
            "city": "HOLLY HILL",
            "state": "SC",
            "postal_code": "290592762",
            "telephone_number": "803-531-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-03",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A",
        "authorized_official_last_name": "WARDLAW",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "STAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "803-531-6900",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Health Centers at Holly Hill",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holly Hill, SC

Sources for this page

Verify at the official NPI Registry.