STATE OF SOUTH CAROLINA (ORANGEBURG COUNTY HEALTH DEPARTMENT) - NPI NUMBER 1184702227

Summary

Provider Name: STATE OF SOUTH CAROLINA (ORANGEBURG COUNTY HEALTH DEPARTMENT)

NPI Number: 1184702227

Clasification: Public Health or Welfare (251K00000X)

Address:
1550 CAROLINA AVE
ORANGEBURG, SC
ZIP 29115

Phone Number: (803) 536-9060



Detailed Information

STATE OF SOUTH CAROLINA is a public health or welfare in Orangeburg, SC. The assigned NPI number for this provider is 1184702227 and is registered as an organization entity type.
The provider Is Doing Business As Orangeburg County Health Department.

The provider's business address is:

1550 CAROLINA AVE
ORANGEBURG, SC
ZIP 29115-944
Phone: (803) 536-9060

The provider's authorized official is Betty H Garren .
The authorized official title is Director, Third Party Administratio and has the following contact phone number (803) 898-3720.

The enumeration date for this NPI number is 11/2/2006 and was last updated on 5/10/2012.

Map - Location of Practice

Similar Providers

NPI Provider Name / Taxonomy
1740604453 ORANGEBURG CO. DSN BOARD
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1003953480 SOUTH CAROLINA DHEC
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1538223334 SOUTH CAROLINA DHEC
Public Health or Welfare

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 251K00000X Public Health or Welfare Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 601249 OTHER SC SELECT HEALTH PROVIDER #
2 000000155826 OTHER SC UNISON HEALTH PLAN OF SC
3 DHEC38 MEDICAID SC
4 Q291310005 MEDICARE ID-TYPE UNSPECIFIED SC MEDICARE PROVIDER NUMBER

NPI Record

No. Field Name Field Value
1 NPI 1184702227
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name STATE OF SOUTH CAROLINA
5 Provider Other Organization Name ORANGEBURG COUNTY HEALTH DEPARTMENT
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 1550 CAROLINA AVE
8 Provider Business Practice Location Address City Name ORANGEBURG
9 Provider Business Practice Location Address State Name SC
10 Provider Business Practice Location Address Postal Code 291154944
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 8035369060
13 Provider Enumeration Date 11/2/2006
14 Last Update Date 5/10/2012
15 Authorized Official Last Name GARREN
16 Authorized Official First Name BETTY
17 Authorized Official Middle Name H
18 Authorized Official Title or Position DIRECTOR, THIRD PARTY ADMINISTRATIO
19 Authorized Official Telephone Number 8038983720
20 Healthcare Provider Taxonomy Code 1 251K00000X
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Other Provider Identifier 1 601249
23 Other Provider Identifier Type Code 1 01
24 Other Provider Identifier State 1 SC
25 Other Provider Identifier Issuer 1 SELECT HEALTH PROVIDER #
26 Other Provider Identifier 2 000000155826
27 Other Provider Identifier Type Code 2 01
28 Other Provider Identifier State 2 SC
29 Other Provider Identifier Issuer 2 UNISON HEALTH PLAN OF SC
30 Other Provider Identifier 3 DHEC38
31 Other Provider Identifier Type Code 3 05
32 Other Provider Identifier State 3 SC
33 Other Provider Identifier 4 Q291310005
34 Other Provider Identifier Type Code 4 04
35 Other Provider Identifier State 4 SC
36 Other Provider Identifier Issuer 4 MEDICARE PROVIDER NUMBER
37 Is Organization Subpart N
38 Authorized Official Name Prefix Text MRS.

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This page was last updated on: 7/15/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.