Organization
EDISTO REGIONAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS DANDRIDGE (PRESIDENT)
(803) 395-2200
Entity
Organization
Contact information
Practice address
215 DORANGE RD, BRANCHVILLE, SC 29432-2241
(803) 274-8400
(803) 274-8817
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
7265
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4574
—
SC
Enumeration date
12/11/2006
Last updated
05/26/2010
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