1083663553 NPI number — AIKEN REGIONAL MEDICAL CENTERS

Table of content: (NPI 1083663553)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083663553 NPI number — AIKEN REGIONAL MEDICAL CENTERS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AIKEN REGIONAL MEDICAL CENTERS
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:
AIKEN REGIONAL MEDICAL CENTERS CRNAS/PSYCHIATRIST/INTERNAL MEDICINE
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:
1083663553
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/20/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 40
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SULLIVANS IS
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29482-0040
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-883-5830
Provider Business Mailing Address Fax Number:
843-883-5829

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
302 UNIVERSITY PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AIKEN
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29801-6302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-641-5622
Provider Business Practice Location Address Fax Number:
803-641-5625
Provider Enumeration Date:
05/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HAMILTON
Authorized Official First Name:
MARY NELL
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF BILLING
Authorized Official Telephone Number:
843-883-5830

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: GP3656 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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