Organization
CLARENDON MEMORIAL HOSPITAL
Active
Other names
Clarendon Pediatric Associates
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SHAUGHNESSY (CFO)
(803) 435-3239
Entity
Organization
Contact information
Practice address
50 E HOSPITAL ST, STE 4B, MANNING, SC 29102-3149
(803) 433-8419
(803) 433-8417
Mailing address
PO BOX 550, ATTN: CREDENTIALING, MANNING, SC 29102-3153
(803) 435-5248
(803) 435-5288
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP6760
—
SC
Enumeration date
11/21/2014
Last updated
03/10/2016
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