1881857027 NPI number — UNIVERSITY OF SOUTH CAROLINA SYSTEM

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 1881857027 NPI number — UNIVERSITY OF SOUTH CAROLINA SYSTEM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY OF SOUTH CAROLINA SYSTEM
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:
Provider Other Organization Name Type Code:
6
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:
1881857027
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/15/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
509 HUBBARD DRIVE
Provider Second Line Business Mailing Address:
UNIVERSITY OF SC SYSTEM
Provider Business Mailing Address City Name:
LANCASTER
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29720
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-313-7104
Provider Business Mailing Address Fax Number:
803-313-7194

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
509 HUBBARD DRIVE
Provider Second Line Business Practice Location Address:
UNIVERSITY OF SC LANCASTER
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-313-7104
Provider Business Practice Location Address Fax Number:
803-313-7194
Provider Enumeration Date:
07/08/2008

Additional Information

Authorized Official

Authorized Official Last Name:
BAKER
Authorized Official First Name:
LYNN
Authorized Official Middle Name:
V.
Authorized Official Title or Position:
DIRECTOR OF CARDIOPULMONARY REHAB.
Authorized Official Telephone Number:
803-313-7104

Provider Taxonomy Codes

  • Taxonomy code: 163WC3500X , with the licence number:  R35052 , 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)





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