1942259221 NPI number — THE REGIONAL MEDICAL CENTER OF ORANGEBURG AND CALHOUN COUNTIES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942259221 NPI number — THE REGIONAL MEDICAL CENTER OF ORANGEBURG AND CALHOUN COUNTIES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE REGIONAL MEDICAL CENTER OF ORANGEBURG AND CALHOUN COUNTIES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HOME CARE OF THE REGIONAL MEDICAL CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942259221
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/13/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1895 SAINT MATTHEWS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORANGEBURG
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29118-2403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-395-2600
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1175 COOK RD STE 325
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORANGEBURG
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29118-8247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-395-2600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
VEGO
Authorized Official First Name:
JOBERT
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CREDENTIALING
Authorized Official Telephone Number:
803-395-4497

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HHA122 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PP0012 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 427110 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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