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General NPI Number Information
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NPI Number | 1528316585
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Entity Type | Organization
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Legal Business Name | CLARENDON MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 08/23/2012
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Last Update Date | 01/09/2015
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Provider Practice Location Address
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Address Line | 10 E HOSPITAL ST SUITE 100
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City | MANNING
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State | SC
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Zip | 29102-3153
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Country | US
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Telephone | 803-435-5212
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Fax | 803-435-3389
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Provider Business Mailing Address
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Address Line | 10 E HOSPITAL ST SUITE 100
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City | MANNING
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State | SC
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Zip | 29102-3153
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Country | US
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Telephone | 803-435-5212
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Fax | 803-435-3389
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Authorized Official
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Title or Position | CEO
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Name | MR. RICHARD STOKES
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Credential |
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Telephone | 803-435-8465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | SC
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