Organization
EDISTO REGIONAL HEALTH SERVICES INC.
Active
Parent organization
EDISTO REGIONAL HEALTH SERVICES INC.
Other names
RMC Primary Care St. Matthews
Organization subpart
Yes
Provider details
NPI number
Legal business name
EDISTO REGIONAL HEALTH SERVICES INC.
Authorized official
CHRISTAL LEANN FULMER (REVENUE INTEGRITY MANAGER)
(803) 395-4248
Entity
Organization
Contact information
Practice address
651A HARRY C RAYSOR DR, ST MATTHEWS, SC 29135-1487
(803) 395-3755
(803) 874-3905
Mailing address
PO BOX 1245, ORANGEBURG, SC 29116-1245
(803) 395-4497
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015
BLUECHOICE
SC
01
—
017
BCBS
SC
01
—
CK8831
RRMEDICARE
SC
01
—
CN8991
RRMEDICARE
SC
05
—
GP5396
—
SC
Enumeration date
08/03/2009
Last updated
07/21/2022
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