Four Holes Indian Organization Edisto Tribal Inc.

NPI #1407250566 in Ridgeville, South Carolina

Provider Information

NPI Number: 1407250566
Entity Type: Organization
Organization Name: Four Holes Indian Organization Edisto Tribal Inc.
Primary Specialty: Clinic/Center
Enumeration Date: Oct 20, 2014
Last Updated: Jul 21, 2022

Practice Location

Address: 1125 RIDGE RD
City: Ridgeville
State: South Carolina
ZIP Code: 29472-7846
Phone: (843) 871-2126

Authorized Official

Name: DONNIE CREEL
Title: CHAIRMAN OF THE BOARD
Phone: (843) 871-2126

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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