Organization
HARTSVILLE, LLC
Active
Other names
Carolina Pines Regional Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNETTA TRAYLOR (DIRECTOR)
(502) 596-6063
Entity
Organization
Contact information
Practice address
1304 W BOBO NEWSOM HWY, HARTSVILLE, SC 29550-4710
(843) 339-2100
(843) 339-4116
Mailing address
680 S 4TH ST, LOUISVILLE, KY 40202-2407
(502) 212-8481
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
SC
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274290
—
SC
05
—
340464
—
SC
05
—
GP2679
—
SC
Enumeration date
12/28/2005
Last updated
06/24/2025
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