NPIMap

Organization Active NPI

Little River Medical Center, Inc.

  • Multi-Specialty Clinic/Center
  • Myrtle Beach, SC
National Provider Identifier
1790592491
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
LITTLE RIVER MEDICAL CENTER, INC.
Practice address
4220 Carolina Exchange Dr
Myrtle Beach, SC 29579-4220
Phone
(843) 663-8000
Fax
(843) 663-8166
NPI assigned
Dec 16, 2024
Organization subpart
Yes
Parent organization
LITTLE RIVER MEDICAL CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Authorized official

Name
Tammy Porter
Title
Provider Enrollment Coordinator
Phone
(843) 663-8000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

4220 Carolina Exchange Dr
Myrtle Beach, SC 29579-4220

Mailing address

PO Box 547
Little River, SC 29566-0547
Phone (843) 663-8294

National Provider Directory

National Provider Directory
Tax ID family
Little River Medical Center Inc26 organizations share this tax ID, including this one
Part of
Little River Medical Center Inc

Other organizations with this tax ID 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1790592491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295660547",
            "telephone_number": "843-663-8294",
            "fax_number": "843-663-8166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 CAROLINA EXCHANGE DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794220",
            "telephone_number": "843-663-8000",
            "fax_number": "843-663-8166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE RIVER MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LITTLE RIVER MEDICAL CENTER, INC.",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT COORDINATOR",
        "authorized_official_telephone_number": "843-663-8000"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.