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Organization
EDISTO REGIONAL HEALTH SERVICES
Active
Organization
EDISTO REGIONAL HEALTH SERVICES
Active
Other names
Edisto Regional Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS DANDRIDGE (PRESIDENT)
(803) 395-2200
Entity
Organization
Contact information
Practice address
2850 PELHAM CT, ORANGEBURG, SC 29118-1400
(803) 531-8500
Mailing address
PO BOX 1245, ORANGEBURG, SC 29116-1245
(803) 395-4499
(803) 536-0998
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
NULL
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4354
—
SC
Enumeration date
05/26/2006
Last updated
08/22/2020
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