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
Public Health or Welfare
1003953480 SOUTH CAROLINA DHEC
Public Health or Welfare
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 Field Definition 1
1 NPI 1184702227 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name STATE OF SOUTH CAROLINA The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider Other Organization Name ORANGEBURG COUNTY HEALTH DEPARTMENT Other name by which the organization provider is or has been known.
6 Provider Other Organization Name Type Code 3 Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
7 Provider First Line Business Practice Location Address 1550 CAROLINA AVE The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Business Practice Location Address City Name ORANGEBURG The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name SC The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 291154944 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 8035369060 The telephone number associated with the location address of the provider being identified.
13 Provider Enumeration Date 11/2/2006 The date the provider was assigned a unique identifier (assigned an NPI).
14 Last Update Date 5/10/2012 The date that a record was last updated or changed.
15 Authorized Official Last Name GARREN The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
16 Authorized Official First Name BETTY The first name of the authorized official.
17 Authorized Official Middle Name H The middle name of the authorized official.
18 Authorized Official Title or Position DIRECTOR, THIRD PARTY ADMINISTRATIO The title or position of the authorized official.
19 Authorized Official Telephone Number 8038983720 The 10-position telephone number of the authorized official.
20 Healthcare Provider Taxonomy Code 1 251K00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Other Provider Identifier 1 601249 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
23 Other Provider Identifier Type Code 1 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
24 Other Provider Identifier State 1 SC
25 Other Provider Identifier Issuer 1 SELECT HEALTH PROVIDER #
26 Other Provider Identifier 2 000000155826 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
27 Other Provider Identifier Type Code 2 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
28 Other Provider Identifier State 2 SC
29 Other Provider Identifier Issuer 2 UNISON HEALTH PLAN OF SC
30 Other Provider Identifier 3 DHEC38 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
31 Other Provider Identifier Type Code 3 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
32 Other Provider Identifier State 3 SC
33 Other Provider Identifier 4 Q291310005 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
34 Other Provider Identifier Type Code 4 04 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
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: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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