Healthcare Provider Details

I. General information

NPI: 1750713038
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: 08/08/2013
Last Update Date: 12/16/2019
Certification Date: 12/16/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 COOK RD STE 145
ORANGEBURG SC
29118-8235
US

IV. Provider business mailing address

PO BOX 1245
ORANGEBURG SC
29116-1245
US

V. Phone/Fax

Practice location:
  • Phone: 803-395-3891
  • Fax: 803-395-2237
Mailing address:
  • Phone: 803-395-4497
  • Fax: 803-395-2237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: JOBERT ARAGON VEGO
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 803-395-4497