Organization
EDISTO REGIONAL HEALTH SERVICES
Active
Other names
COPELAND MEDICAL CARE
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS DANDRIDGE I (PRESIDENT)
(803) 395-2200
Entity
Organization
Contact information
Practice address
2850 PELHAM CT, ORANGEBURG, SC 29118-1400
(803) 655-6132
(803) 655-6173
Mailing address
PO BOX 1245, ORANGEBURG, SC 29116-1245
(803) 395-4499
(803) 395-4480
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
APN652
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3748
—
SC
Enumeration date
08/02/2006
Last updated
10/24/2007
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