Healthcare Provider Details

I. General information

NPI: 1649525387
Provider Name (Legal Business Name): SC REGIONAL HEALTH SYSTEM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2012
Last Update Date: 07/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 REYNOLDS RD
BARNWELL SC
29812-1573
US

IV. Provider business mailing address

811 REYNOLDS RD
BARNWELL SC
29812-1573
US

V. Phone/Fax

Practice location:
  • Phone: 803-259-1000
  • Fax: 803-541-4365
Mailing address:
  • Phone: 803-259-1000
  • Fax: 803-541-4365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: MARY T. VALLIANT
Title or Position: CEO
Credential:
Phone: 803-541-4365