Healthcare Provider Details

I. General information

NPI: 1578402764
Provider Name (Legal Business Name): MEDICAL UNIVERSITY HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7620 GARNERS FERRY RD
COLUMBIA SC
29209-3810
US

IV. Provider business mailing address

PO BOX 23469
NEW YORK NY
10087-3469
US

V. Phone/Fax

Practice location:
  • Phone: 803-365-8035
  • Fax:
Mailing address:
  • Phone: 843-792-2311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KARYN RAE
Title or Position: CHIEF, PAYOR RELATIONS
Credential:
Phone: 843-876-1344