Organization
EDISTO REGIONAL HEALTH SERVICES INC.
Active
Parent organization
EDISTO REGIONAL HEALTH SERVICES INC.
Other names
RMC Primary Care Bamberg
Organization subpart
Yes
Provider details
NPI number
Legal business name
EDISTO REGIONAL HEALTH SERVICES INC.
Authorized official
MS. LIZA PORTERFIELD (C.F.O.)
(803) 395-4458
Entity
Organization
Contact information
Practice address
498 NORTH STREET, BAMBERG, SC 29003-1377
(803) 245-5144
Mailing address
PO BOX 1245, ORANGEBURG, SC 29116-1245
(803) 395-4497
(803) 395-2237
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
19072
SC
207V00000X
Obstetrics & Gynecology Physician
22299
SC
261QR1300X
Rural Health Clinic/Center
Primary
19072
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017
TRICARE
SC
01
—
019
BLUECHOICE
SC
01
—
CK8831
RRMEDICARE
SC
01
—
CN8991
RRMEDICARE
SC
05
—
GP5405
—
SC
01
—
RHC199
MEDICARE RURAL HEALTH
SC
Enumeration date
03/22/2010
Last updated
06/01/2017
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