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Organization
ALLENDALE COUNTY HOSPITAL BOARD
Active
Organization
ALLENDALE COUNTY HOSPITAL BOARD
Active
Parent organization
ALLENDALE COUNTY HOSPITAL
Other names
Carolina Medical Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALLENDALE COUNTY HOSPITAL
Authorized official
MR. KEN HIATT (ADMINISTRATOR)
(803) 632-3311
Entity
Organization
Contact information
Practice address
1787 ALLENDALE FAIRFAX HWY, FAIRFAX, SC 29827-9133
(803) 632-3311
(803) 632-3415
Mailing address
PO BOX 218, FAIRFAX, SC 29827-0218
(803) 632-3311
(803) 632-3415
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
HTL-041
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20061068
SELECT HEALTH
SC
05
—
GP2791
—
SC
Enumeration date
09/26/2006
Last updated
05/14/2013
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