Organization
KERSHAW HOSPITAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL A WIECHART (PRESIDENT AND CEO)
(615) 844-9800
Entity
Organization
Contact information
Practice address
1315 ROBERTS ST, CAMDEN, SC 29020-3737
(803) 713-6376
Mailing address
PO BOX 7003, CAMDEN, SC 29020-7003
(803) 713-6376
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42D0248614
CLIA#
SC
05
—
IC0031
—
SC
Enumeration date
11/16/2006
Last updated
09/16/2016
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