Healthcare Provider Details

I. General information

NPI: 1023457389
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: 06/20/2013
Last Update Date: 11/09/2022
Certification Date: 11/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 COOK RD STE 320
ORANGEBURG SC
29118-8247
US

IV. Provider business mailing address

PO BOX 1245
ORANGEBURG SC
29116-1245
US

V. Phone/Fax

Practice location:
  • Phone: 803-395-3960
  • Fax: 803-395-2237
Mailing address:
  • Phone: 803-395-4497
  • Fax: 803-395-2237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTAL LEANN FULMER
Title or Position: REVENUE INTEGRITY MANAGER
Credential:
Phone: 803-395-4248