GEORGETOWN PEDIATRIC CENTER – NPI #1316345846
Clinic/Center

GEORGETOWN PEDIATRIC CENTER is an AHC clinic located in GEORGETOWN, SC. NPPES has assigned the NPI number 1316345846 to GEORGETOWN PEDIATRIC CENTER on December 16, 2014. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “GEORGETOWN PEDIATRIC CENTER” is a dba name, the actual legal business name for this organization is ST. JAMES HEALTH AND WELLNESS INC.. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 4 years ago on Jun 21, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GEORGETOWN PEDIATRIC CENTER below.

NPI Profile for
ST. JAMES HEALTH AND WELLNESS INC.

NPI Number
1316345846
Enumeration Date

(more than 11 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ST. JAMES HEALTH AND WELLNESS INC.
Doing Business As (dba): GEORGETOWN PEDIATRIC CENTER
Primary location
57 JESSAMINE AVE
GEORGETOWN, SC 29440-5837
Phone: (843) 887-3274 Fax: (843) 887-3274
1 Other location(s):
1189 Tibwin Rd
Mc Clellanville, SC 29458-9405
Phone: (843) 990-7993
Fax: (843) 887-3817
Mailing address
PO BOX 608
MC CLELLANVILLE, SC 29458-0608
Phone: (843) 887-3274 Fax: (842) 887-3817
Organization Subpart
No
Authorized Official
SANDRA GILLIARD
CEO
Phone: (184) 399-0799
Updated
Certification Date
Jun 21, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.