Healthcare Provider Details

I. General information

NPI: 1962975466
Provider Name (Legal Business Name): MEDICAL UNIVERSITY HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2019
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2829 E HIGHWAY 76
MULLINS SC
29574-6035
US

IV. Provider business mailing address

PO BOX 23467
NEW YORK NY
10087-3467
US

V. Phone/Fax

Practice location:
  • Phone: 843-431-2000
  • Fax:
Mailing address:
  • Phone: 843-792-2311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: KARYN RAE
Title or Position: DIRECTOR
Credential:
Phone: 843-876-1344