Organization
AMERIGROUP COMMUNITY CARE OF SOUTH CAROLI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON BRUMLEY (SENIOR VICE PRESIDENT, REGULATORY S)
(757) 962-6452
Entity
Organization
Contact information
Practice address
250 BERRYHILL RD, SUITE 210, COLUMBIA, SC 29210-6470
(803) 551-2377
Mailing address
250 BERRYHILL ROAD, SUITE 210, COLUMBIA, SC 29210-6470
(803) 551-2377
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
161350
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HM2400
—
SC
Enumeration date
07/30/2007
Last updated
11/30/2011
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