Organization
ANDERSON DISTRICT 4
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HEIDI B MCCAULLEY RN BSN (REGISTERED NURSE)
(864) 403-2200
Entity
Organization
Contact information
Practice address
458 RIVERSIDE ST, PENDLETON, SC 29670-1211
(864) 403-2200
(864) 646-8025
Mailing address
458 RIVERSIDE ST, PENDLETON, SC 29670-1211
(864) 403-2200
(864) 646-8025
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
68523
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0404
—
SC
Enumeration date
01/09/2013
Last updated
01/09/2013
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