Basic Information
Provider Information
NPI: 1457447245
EntityType: 2
ReplacementNPI:  
OrganizationName: THE REGIONAL MEDICAL CENTER OF ORANGEBURG AND CALHOUN COUNTIES
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
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Mailing Information
Address1: PO BOX 1245
Address2:  
City: ORANGEBURG
State: SC
PostalCode: 291161245
CountryCode: US
TelephoneNumber: 8033954497
FaxNumber: 8035360998
Practice Location
Address1: 3000 SAINT MATTHEWS RD
Address2:  
City: ORANGEBURG
State: SC
PostalCode: 291181442
CountryCode: US
TelephoneNumber: 8033952200
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/05/2006
LastUpdateDate: 04/10/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: PORTERFIELD
AuthorizedOfficialFirstName: LIZA
AuthorizedOfficialMiddleName: M
AuthorizedOfficialTitleorPosition: C.F.O.
AuthorizedOfficialTelephone: 8033952224
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: THE REGIONAL MEDICAL CENTER OF ORANGEBURG AND CALHOUN COUNTIES
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332BC3200X  Y SuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment

No ID Information.


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