Black River Healthcare, Inc.

NPI #1275566440 in Timmonsville, South Carolina

Provider Information

NPI Number: 1275566440
Entity Type: Organization
Organization Name: Black River Healthcare, Inc.
Subpart: Yes (part of a larger organization)
Parent Organization: BLACK RIVER HEALTHCARE, INC.
Primary Specialty: Family Medicine
Enumeration Date: Jul 9, 2006
Last Updated: Jan 6, 2009

Practice Location

Address: 206 EAST MARKET STREET
City: Timmonsville
State: South Carolina
ZIP Code: 29161
Phone: (803) 433-1216

Authorized Official

Name: MRS. BARBARA F. BROOKS
Title: CHIEF EXECUTIVE OFFICER
Phone: (803) 433-1216

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Registered Nurse	163W00000X
Pediatrics	208000000X
General Practice	208D00000X
Clinic/Center - Rural Health — Rural Health	261QR1300X
Family Medicine	207Q00000X	Primary

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