BLACK RIVER HEALTHCARE INC. NPI 1508809542

NPI Information

NPI: 1508809542
Provider Name: BLACK RIVER HEALTHCARE, INC.
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Other Name: BRH - OLANTA
Address: 139 MAIN STREET
OLANTA, SC
ZIP 29114
Phone: (803) 433-1216

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NPI Details

BLACK RIVER HEALTHCARE, INC. is a family medicine in Olanta, SC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. BLACK RIVER HEALTHCARE, INC. NPI is 1508809542. The provider is registered as an organization entity type.
The provider Other Name Is Brh - Olanta.

The provider's business location address is:

139 MAIN STREET
OLANTA, SC
ZIP 29114
Phone: (803) 433-1216
Fax: (803) 433-6796

The provider's authorized official is Barbara Brooks .
The authorized official title is Chief Executive Officer and has the following contact phone number (803) 433-1216.

The enumeration date for this NPI number is 6/14/2006 and was last updated on 4/8/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health	27146	SOUTH CAROLINA	No
2	363LF0000X	Nurse Practitioner	Family			No
3	207R00000X	Internal Medicine				No
4	207Q00000X	Family Medicine				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	421836	MEDICARE OSCAR/CERTIFICATION	SOUTH CAROLINA
2	4400	MEDICARE ID-TYPE UNSPECIFIED	SOUTH CAROLINA	OLANTA MEDICARE NUMBER
3	4400	OTHER	SOUTH CAROLINA	MEDICARE PART B

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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