Healthcare Provider Details

I. General information

NPI: 1982604021
Provider Name (Legal Business Name): GEORGETOWN MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 04/10/2020
Certification Date: 04/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 BLACK RIVER RD
GEORGETOWN SC
29440-3304
US

IV. Provider business mailing address

PO BOX 421718
GEORGETOWN SC
29442-4203
US

V. Phone/Fax

Practice location:
  • Phone: 843-527-7000
  • Fax:
Mailing address:
  • Phone: 843-527-7142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberHTL-0007
License Number StateSC

VIII. Authorized Official

Name: ELIZABETH S WARD
Title or Position: EVP & CFO
Credential:
Phone: 843-527-7000