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General NPI Number Information
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NPI Number | 1215991682
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Entity Type | Organization
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Legal Business Name | MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE, INC
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 02/24/2021
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Provider Practice Location Address
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Address Line | 2210 ENTERPRISE DR
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City | FLORENCE
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State | SC
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Zip | 29501-1109
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Country | US
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Telephone | 843-669-3050
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Fax | 843-669-5368
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Provider Business Mailing Address
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Address Line | 2210 ENTERPRISE DR
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City | FLORENCE
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State | SC
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Zip | 29501-1109
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Country | US
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Telephone | 843-777-3050
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Fax | 843-777-5368
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Authorized Official
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Title or Position | SR VP AND CFO
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Name | 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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HHA-085
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License Number State | SC
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