Healthcare Provider Details

I. General information

NPI: 1467411462
Provider Name (Legal Business Name): LAURENS COUNTY HEALTH CARE SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22725 HIGHWAY 76 E ANESTHESIA DEPT
CLINTON SC
29325-7527
US

IV. Provider business mailing address

PO BOX 1499
LAURENS SC
29360-1499
US

V. Phone/Fax

Practice location:
  • Phone: 864-833-9100
  • Fax: 770-237-1124
Mailing address:
  • Phone: 770-237-1089
  • Fax: 770-237-1124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateSC

VIII. Authorized Official

Name: DAN ELMER
Title or Position: CFO
Credential:
Phone: 864-833-9100