Basic Information
| Provider Information | |||||||||
| NPI: | 1861096778 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 CASHUA FERRY RD | ||||||||
| Address2: | |||||||||
| City: | DARLINGTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295328488 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437774200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 701 CASHUA FERRY RD | ||||||||
| Address2: | |||||||||
| City: | DARLINGTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295328488 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437774200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/23/2020 | ||||||||
| LastUpdateDate: | 11/23/2020 | ||||||||
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| AuthorizedOfficialLastName: | ERVIN | ||||||||
| AuthorizedOfficialFirstName: | SAMUEL | ||||||||
| AuthorizedOfficialMiddleName: | FULTON | ||||||||
| AuthorizedOfficialTitleorPosition: | SR. VICE PRESIDENT AND CFO | ||||||||
| AuthorizedOfficialTelephone: | 8437772910 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | MCLEOD HEALTH | ||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | III | ||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 11/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | Y | Hospital Units | Psychiatric Unit |
No ID Information.