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Organization
ORANGEBURG FIVE
Active
Organization
ORANGEBURG FIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. WANDA THOMAS (MEDICAID SPECIALIST)
(803) 533-7970
Entity
Organization
Contact information
Practice address
578 ELLIS AVE, ORANGEBURG, SC 29115-5022
(803) 533-7970
(803) 535-1610
Mailing address
578 ELLIS AVE, ORANGEBURG, SC 29115-5022
(803) 533-7970
(803) 535-1610
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
NULL
Other
Enumeration date
07/17/2012
Last updated
07/17/2012
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