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General NPI Number Information
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NPI Number | 1578633889
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Entity Type | Organization
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Legal Business Name | STATE OF SOUTH CAROLINA
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 2111 WILSON ROAD
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City | NEWBERRY
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State | SC
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Zip | 29108
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Country | US
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Telephone | 803-321-2170
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Fax | 803-321-2300
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Provider Business Mailing Address
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Address Line | 400 OTARRE PKWY
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City | CAYCE
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State | SC
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Zip | 29033-3751
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Country | US
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Telephone | 803-898-1553
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Fax | 803-898-2262
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Authorized Official
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Title or Position | DIRECTOR OF PATIENT BILLING
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Name | ZANNA PERKINS
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Credential |
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Telephone | 803-898-1553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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