| Black River Healthcare, Inc. | |
|
520 Thurgood Marshall Blvd. Suite B Kingstree SC 29556 | |
| (843) 355-5628 | |
| (843) 355-6072 |
| Full Name | Black River Healthcare, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 520 Thurgood Marshall Blvd., Kingstree, South Carolina |
| Authorized Official Name and Position | Barbara Brooks (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8034331216 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Black River Healthcare, Inc. 12 W South St Manning SC 29102-2925 Ph: (803) 433-1216 | Black River Healthcare, Inc. 520 Thurgood Marshall Blvd. Suite B Kingstree SC 29556 Ph: (843) 355-5628 |
| NPI Number | 1497798599 |
|---|---|
| Provider Enumeration Date | 06/14/2006 |
| Last Update Date | 04/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497798599 | NPI | - | NPPES |
| 4397 | Other | SC | MEDICARE PART B |
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