# EDISTO REGIONAL HEALTH SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Edisto Regional Pediatrics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982650107
- **Authorized official:** THOMAS DANDRIDGE (PRESIDENT)
- **Authorized official phone:** (803) 395-2200

## Contact information

- **Practice address:** 2850 PELHAM CT, ORANGEBURG, SC 29118-1400
- **Practice address phone:** (803) 531-8500
- **Mailing address:** PO BOX 1245, ORANGEBURG, SC 29116-1245
- **Mailing address phone:** (803) 395-4499
- **Mailing address fax:** (803) 536-0998

## Taxonomy

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

## Other

- **Enumeration date:** 05/26/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP4354 | — | SC |