Healthcare Provider Details

I. General information

NPI: 1780633065
Provider Name (Legal Business Name): THE REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 10/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1895 SAINT MATTHEWS RD
ORANGEBURG SC
29118-2403
US

IV. Provider business mailing address

1895 SAINT MATTHEWS RD
ORANGEBURG SC
29118-2403
US

V. Phone/Fax

Practice location:
  • Phone: 803-395-2600
  • Fax: 803-395-2594
Mailing address:
  • Phone: 803-395-2600
  • Fax: 803-395-2859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberHPC037
License Number StateSC

VIII. Authorized Official

Name: MS. LISA M GOODLETT
Title or Position: CFO
Credential:
Phone: 803-533-2200