1699914093 NPI number — UNION HOSPITAL DISTRICT

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 1699914093 NPI number — UNION HOSPITAL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNION HOSPITAL DISTRICT
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:
CHA- WHITMIRE 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:
1699914093
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/03/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 MAIN STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITMIRE
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29178
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-694-3820
Provider Business Mailing Address Fax Number:
803-694-4112

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITMIRE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29178
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-694-3820
Provider Business Practice Location Address Fax Number:
803-694-4112
Provider Enumeration Date:
02/10/2009

Additional Information

Authorized Official

Authorized Official Last Name:
VAUGHAN
Authorized Official First Name:
PAMELA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
864-427-2401

Provider Taxonomy Codes

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

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

  • Identifier: GP5095 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com