Basic Information
| Provider Information | |||||||||
| NPI: | 1255367637 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OCONEE MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 751710 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282751710 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 298 MEMORIAL DR | ||||||||
| Address2: | |||||||||
| City: | SENECA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296729443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8648823351 | ||||||||
| FaxNumber: | 8648857619 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2006 | ||||||||
| LastUpdateDate: | 09/09/2011 | ||||||||
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| AuthorizedOfficialLastName: | SCARBROUGH | ||||||||
| AuthorizedOfficialFirstName: | GREG | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP FINANCE/CFO | ||||||||
| AuthorizedOfficialTelephone: | 8648857600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251J00000X | N | Agencies | Nursing Care | 282N00000X | HTL062 | SC | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 400097 | 05 | SC | MEDICAID | 500345 | 05 | SC | MEDICAID | DPE039 | 05 | SC | MEDICAID | GP1228 | 05 | SC | MEDICAID | 247902 | 05 | SC | MEDICAID | 354027 | 05 | SC | MEDICAID | IC0030 | 05 | SC | MEDICAID | DE1237 | 05 | SC | MEDICAID | GP2452 | 05 | SC | MEDICAID |