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NPI Code Detail

MEDICARE: MCLEOD HEALTH CLARENDON

MEDICARE: MCLEOD HEALTH CLARENDON
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
1207Q00000XFamily Medicine Physician
2261QR1300XRural Health Clinic/Center

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
287-3801OTHERSCMEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1962851097
Entity Type Code : Organization
Provider Name (Legal Business Name) : MCLEOD HEALTH CLARENDON
Provider Business Mailing Address
First Line : 200 E HOSPITAL ST
Second Line :
City : MANNING
State : SC
Zip : 29102-3160
Country : US
Telephone Number : 803-433-0439
Fax Number :
Provider Business Practice Location Address
First Line : 200 E HOSPITAL ST
Second Line :
City : MANNING
State : SC
Zip : 29102-3160
Country : US
Telephone Number : 803-433-0439
Fax Number :
Authorized Official
Title or Position : SR VICE PRESIDENT AND CFO
Name : MR. SAMUEL FULTON ERVIN III
Credential :
Telephone Number : 843-777-2910
Provider Enumeration Date : 06/09/2016
Last Update Date : 04/17/2020

Similar Medicare Providers

1558366039 — DR. ROBERT S EAGERTON JR. M.D.
Practice Location Address:
200 E HOSPITAL ST
MANNING, SC
29102-3160
Practice Phone: 803-433-0439
Practice Fax: 803-433-9840
1700093705 — ROBERT S. EAGERTON, JR. M.D.,LLC
Practice Location Address:
200 E HOSPITAL ST
MANNING, SC
29102-3160
Practice Phone: 803-433-0439
Practice Fax: 803-433-9840
1225291206 — MANNING DIAGNOSTICS LLC
Practice Location Address:
202 E HOSPITAL ST
MANNING, SC
29102-3160
Practice Phone: 803-433-2021
Practice Fax:
1821380197 — CLARENDON MEMORIAL HOSPITAL
Practice Location Address:
200 E HOSPITAL ST
MANNING, SC
29102-3160
Practice Phone: 803-433-0439
Practice Fax: 803-433-9840
1336413681 — CLARENDON MEMORIAL HOSPITAL
Practice Location Address:
200 E HOSPITAL ST
MANNING, SC
29102-3160
Practice Phone: 803-433-0439
Practice Fax: 803-433-9840
1659722411 — DR. CARMEN CRIBB ROBERTS D.O.
Practice Location Address:
200 E HOSPITAL ST
MANNING, SC
29102-3160
Practice Phone: 803-433-0439
Practice Fax: 803-433-9840

Directions to “MCLEOD HEALTH CLARENDON ” Practice Location

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