Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Black River Healthcare, Inc

Organization Family Medicine Physician · NPI 1508809542

Black River Healthcare, Inc provides Family Medicine Physician services in Olanta, South Carolina. Licensed in South Carolina. Registered with an NPI since 2006.

Licensed in
SC
In the registry since
2006
Specialties on file
4
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

139 Main St
Olanta, SC 29114 Not confirmed with CMS for 18 years — call before visiting
Phone: (803) 433-1216
Fax: (803) 433-6796
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Rural Health Clinic/Center Taxonomy 261QR1300X · Licence 27146 (SC)
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1508809542
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationBlack River Healthcare, Inc
Authorized official Barbara Brooks — Chief Executive Officer · (803) 433-1216
Other names Brh - Olanta
NPI enumeratedJune 14, 2006
Last updated in NPPESApril 8, 2008
Mailing addressPo Box 578, Manning, SC 29102-0578

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