Healthcare Provider Details

I. General information

NPI: 1083663553
Provider Name (Legal Business Name): AIKEN REGIONAL MEDICAL CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 12/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 UNIVERSITY PKWY
AIKEN SC
29801-6302
US

IV. Provider business mailing address

PO BOX 40
SULLIVANS IS SC
29482-0040
US

V. Phone/Fax

Practice location:
  • Phone: 803-641-5622
  • Fax: 803-641-5625
Mailing address:
  • Phone: 843-883-5830
  • Fax: 843-883-5829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MARY NELL HAMILTON
Title or Position: DIRECTOR OF BILLING
Credential:
Phone: 843-883-5830