Basic Information
| Provider Information | |||||||||
| NPI: | 1942696422 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CLARENDON MEMORIAL HOSPITAL | ||||||||
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| OtherOrganizationName: | CLARENDON ORTHOPAEDIC ASSOCIATES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 50 E HOSPITAL ST | ||||||||
| Address2: | SUITE 6 | ||||||||
| City: | MANNING | ||||||||
| State: | SC | ||||||||
| PostalCode: | 291023149 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8034333065 | ||||||||
| FaxNumber: | 8034330135 | ||||||||
| Practice Location | |||||||||
| Address1: | 50 E HOSPITAL ST | ||||||||
| Address2: | SUITE 6 | ||||||||
| City: | MANNING | ||||||||
| State: | SC | ||||||||
| PostalCode: | 291023149 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8034333065 | ||||||||
| FaxNumber: | 8034330135 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2015 | ||||||||
| LastUpdateDate: | 04/10/2015 | ||||||||
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| AuthorizedOfficialLastName: | STOKES | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8034353235 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.