Healthcare Provider Details

I. General information

NPI: 1427004738
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: 05/26/2006
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 WILLIAM H JOHNSON ST STE 290
FLORENCE SC
29506-2769
US

IV. Provider business mailing address

PO BOX 100567
FLORENCE SC
29502-0567
US

V. Phone/Fax

Practice location:
  • Phone: 843-777-6000
  • Fax: 843-777-5035
Mailing address:
  • Phone: 843-777-4428
  • Fax: 843-777-5035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code364SC2300X
TaxonomyChronic Care Clinical Nurse Specialist
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