Healthcare Provider Details

I. General information

NPI: 1063597987
Provider Name (Legal Business Name): STATE OF SOUTH CAROLINA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1228 COLONIAL COMMONS CT
LANCASTER SC
29720-2215
US

IV. Provider business mailing address

400 OTARRE PKWY
CAYCE SC
29033-3751
US

V. Phone/Fax

Practice location:
  • Phone: 803-286-9948
  • Fax: 803-286-5418
Mailing address:
  • Phone: 803-898-1553
  • Fax: 803-898-2262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State

VIII. Authorized Official

Name: ZANNA PERKINS
Title or Position: DIRECTOR PATIENT BILLING
Credential:
Phone: 803-898-1553