Healthcare Provider Details

I. General information

NPI: 1922063858
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: 04/20/2006
Last Update Date: 03/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 COOK RD SUITE 215
ORANGEBURG SC
29118-8201
US

IV. Provider business mailing address

PO BOX 1245
ORANGEBURG SC
29116-1245
US

V. Phone/Fax

Practice location:
  • Phone: 803-531-0126
  • Fax: 803-536-5122
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 NumberDE2770
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number19837
License Number StateSC

VIII. Authorized Official

Name: MRS. CATHY J SOLES
Title or Position: PRACTICE MANAGER
Credential:
Phone: 803-531-0126