# MONCRIEF ARMY COMMUNITY HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MONCRIEF ARMY COMMUNITY HOSPITAL
- **Other names:** CBMH MONCRIEF-JACKSON
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1972823722
- **Legal business name:** MONCRIEF ARMY COMMUNITY HOSPITAL
- **Authorized official:** WILLIE WARREN (CHIEF, UBO)
- **Authorized official phone:** (803) 751-0472

## Contact information

- **Practice address:** 1021 PINNANCLE POINT, MONCRIEF MEDICAL HOME-JACKSON, COLUMBIA, SC 29223-5740
- **Practice address phone:** (803) 751-6971
- **Mailing address:** 4500 STUART ST, BOX 497 - BILLING OFFICE, COLUMBIA, SC 29207-5700
- **Mailing address phone:** (803) 751-0472

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 06/03/2010
- **Last updated:** 04/08/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1386652956 | PARENT FACILITY NPI 2 | — |