Healthcare Provider Details

I. General information

NPI: 1063449361
Provider Name (Legal Business Name): ABBEVILLE COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 THOMSON CIR
ABBEVILLE SC
29620
US

IV. Provider business mailing address

PO BOX 887
ABBEVILLE SC
29620-0887
US

V. Phone/Fax

Practice location:
  • Phone: 864-366-5011
  • Fax: 864-366-3317
Mailing address:
  • Phone: 864-336-3279
  • Fax: 864-366-3317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License NumberHTL-098
License Number StateSC

VIII. Authorized Official

Name: MATTHEW TOLBERT LOGAN
Title or Position: PRESIDENT/ CEO
Credential:
Phone: 864-725-4780