MEDICARE: THE REGIONAL MEDICAL CENTER OF ORANGEBURG AND CALHOUN COUNTIES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1588090088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE REGIONAL MEDICAL CENTER OF ORANGEBURG AND CALHOUN COUNTIES

Provider Business Mailing Address
First Line	:	PO BOX 1245
Second Line	:
City	:	ORANGEBURG
State	:	SC
Zip	:	29116-1245
Country	:	US
Telephone Number	:	803-395-4497
Fax Number	:	803-395-2237

Provider Business Practice Location Address
First Line	:	1097A COOK RD # X
Second Line	:
City	:	ORANGEBURG
State	:	SC
Zip	:	29118-8209
Country	:	US
Telephone Number	:	803-534-5110
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	JOBERT ARAGON VEGO
Credential	:
Telephone Number	:	803-395-4497

Provider Enumeration Date	:	09/17/2013
Last Update Date	:	06/12/2014

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