| Four Holes Indian Organization Edisto Tribal Inc. | |
|
1125 Ridge Rd Ridgeville SC 29472-7846 | |
| (843) 871-2126 | |
| (843) 832-6019 |
| Full Name | Four Holes Indian Organization Edisto Tribal Inc. |
|---|---|
| Speciality | Clinic/center |
| Location | 1125 Ridge Rd, Ridgeville, South Carolina |
| Authorized Official Name and Position | Donnie Creel (CHAIRMAN OF THE BOARD) |
| Authorized Official Contact | 8438712126 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Four Holes Indian Organization Edisto Tribal Inc. 1125 Ridge Rd Ridgeville SC 29472-7846 Ph: (843) 871-2126 | Four Holes Indian Organization Edisto Tribal Inc. 1125 Ridge Rd Ridgeville SC 29472-7846 Ph: (843) 871-2126 |
| NPI Number | 1407250566 |
|---|---|
| Provider Enumeration Date | 10/20/2014 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407250566 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (South Carolina) | Primary |