Healthcare Provider Details

I. General information

NPI: 1376515197
Provider Name (Legal Business Name): MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 02/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 CASHUA FERRY RD
DARLINGTON SC
29532-8488
US

IV. Provider business mailing address

PO BOX 3239
FLORENCE SC
29502-3239
US

V. Phone/Fax

Practice location:
  • Phone: 843-398-8500
  • Fax: 843-398-7028
Mailing address:
  • Phone: 843-398-8500
  • Fax: 843-398-7028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL FULTON ERVIN III
Title or Position: SR VP AND CFO
Credential:
Phone: 843-777-2910