Healthcare Provider Details

I. General information

NPI: 1245266709
Provider Name (Legal Business Name): OCONEE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 09/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 KEOWEE SCHOOL RD
SENECA SC
29672-6743
US

IV. Provider business mailing address

390 KEOWEE SCHOOL RD
SENECA SC
29672-6743
US

V. Phone/Fax

Practice location:
  • Phone: 864-888-8411
  • Fax: 864-886-9018
Mailing address:
  • Phone: 864-888-8411
  • Fax: 864-886-9018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License NumberHHA164
License Number StateSC

VIII. Authorized Official

Name: GREG SCARBROUGH
Title or Position: VP FINANCE/CFO
Credential:
Phone: 864-885-7600