Basic Information
| Provider Information | |||||||||
| NPI: | 1447475942 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LAURENS COUNTY HEALTH CARE SYSTEM | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | LAURENS COUNTY HOSPITAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22725 HIGHWAY 76 E | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 293257527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8648339100 | ||||||||
| FaxNumber: | 8648339477 | ||||||||
| Practice Location | |||||||||
| Address1: | 22725 HIGHWAY 76 E | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 293257527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8648339100 | ||||||||
| FaxNumber: | 8648339477 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | DIALBERTO | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8648339151 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM2500X | Y | Ambulatory Health Care Facilities | Clinic/Center | Medical Specialty |
No ID Information.