Organization
ALLENDALE COUNTY HOSPITAL BOARD
Active
Other names
Laffitte and Warren Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEN HIATT (ADMINISTRATOR)
(803) 632-3311
Entity
Organization
Contact information
Practice address
623 MEMORIAL AVE N, ALLENDALE, SC 29810-2715
(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
—
20044797
SELECT HEALTH
SC
01
—
7962704
AETNA
SC
05
—
GP3474
—
SC
Enumeration date
09/20/2006
Last updated
05/14/2013
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