MEDICARE: CLARENDON MEMORIAL HOSPITAL

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	314000000X	Skilled Nursing Facility	NCF736	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588645709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLARENDON MEMORIAL HOSPITAL

Provider Business Mailing Address
First Line	:	PO BOX 1159
Second Line	:
City	:	SUMMERTON
State	:	SC
Zip	:	29148-1159
Country	:	US
Telephone Number	:	803-485-2317
Fax Number	:	803-485-2708

Provider Business Practice Location Address
First Line	:	1527 URBANA RD
Second Line	:
City	:	SUMMERTON
State	:	SC
Zip	:	29148-1159
Country	:	US
Telephone Number	:	803-485-2317
Fax Number	:	803-485-2708

Authorized Official
Title or Position	:	CFO
Name	:	MS. CHRISTIE H BROWDER
Credential	:
Telephone Number	:	803-433-2005

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	02/08/2022

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Directions to “CLARENDON MEMORIAL HOSPITAL ” Practice Location

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