Healthcare Provider Details
I. General information
NPI: 1003998956
Provider Name (Legal Business Name): THE REGIONAL MEDICAL CENTER OF ORANGEBURG AND CALHOUN COUNTIES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/19/2006
Last Update Date: 10/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3000 ST. MATTHEWS ROAD
ORANGEBURG SC
29118-1442
US
IV. Provider business mailing address
PO BOX 1245
ORANGEBURG SC
29116-1245
US
V. Phone/Fax
- Phone: 803-395-2200
- Fax:
- Phone: 803-395-4497
- Fax: 803-536-0998
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHERYL
S
MASON
Title or Position: C.F.O.
Credential:
Phone: 803-395-2224