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General NPI Number Information
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NPI Number | 1124487541
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Entity Type | Organization
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Legal Business Name | MCLEOD MEDICAL CENTER-DILLON
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Dates
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Enumeration Date | 02/12/2016
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Last Update Date | 05/22/2019
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Provider Practice Location Address
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Address Line | 301 E JACKSON ST
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City | DILLON
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State | SC
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Zip | 29536-2509
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Country | US
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Telephone | 843-774-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 301 E JACKSON ST
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City | DILLON
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State | SC
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Zip | 29536-2509
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SR. VP & CFO
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Name | MR. SAMUEL FULTON ERVIN III
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Credential |
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Telephone | 843-777-2910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number | HTL-0631
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License Number State | SC
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