Healthcare Provider Details

I. General information

NPI: 1235172420
Provider Name (Legal Business Name): HAMPTON REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 04/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 CAROLINA AVE. WEST
VARNVILLE SC
29944
US

IV. Provider business mailing address

PO BOX 12
COLUMBIA SC
29202
US

V. Phone/Fax

Practice location:
  • Phone: 803-454-2613
  • Fax: 803-765-1732
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: DAVE H HAMILL
Title or Position: CEO
Credential:
Phone: 803-943-1251