Healthcare Provider Details

I. General information

NPI: 1093154700
Provider Name (Legal Business Name): RMC-BARNWELL HEALTHCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 06/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 REYNOLDS RD
BARNWELL SC
29812-1573
US

IV. Provider business mailing address

3446 WINDER HWY STE M-218
FLOWERY BRANCH GA
30542-3007
US

V. Phone/Fax

Practice location:
  • Phone: 803-259-1000
  • Fax:
Mailing address:
  • Phone: 770-904-6731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberHTL0485
License Number StateSC

VIII. Authorized Official

Name: PHILIP H EASTMAN III
Title or Position: PRESIDENT
Credential:
Phone: 770-904-6731