# CLARENDON MEMORIAL HOSPITAL

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Clarendon Pediatric Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225435134
- **Authorized official:** JOHN SHAUGHNESSY (CFO)
- **Authorized official phone:** (803) 435-3239

## Contact information

- **Practice address:** 50 E HOSPITAL ST, STE 4B, MANNING, SC 29102-3149
- **Practice address phone:** (803) 433-8419
- **Practice address fax:** (803) 433-8417
- **Mailing address:** PO BOX 550, ATTN: CREDENTIALING, MANNING, SC 29102-3153
- **Mailing address phone:** (803) 435-5248
- **Mailing address fax:** (803) 435-5288

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | Yes |
| 208000000X | Pediatrics Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/21/2014
- **Last updated:** 03/10/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP6760 | — | SC |