Organization
CLARENDON ONE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSE H. WILDER (SUPERINTENDENT)
(803) 485-2325
Entity
Organization
Contact information
Practice address
12 SOUTH CHURCH STREET, SUMMERTON, SC 29148-0038
(803) 485-2325
(803) 485-7065
Mailing address
PO BOX 38, 12 SOUTH CHURCH STREET, SUMMERTON, SC 29148-0038
(803) 485-2325
(803) 485-7065
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD1401
—
SC
Enumeration date
01/31/2007
Last updated
08/22/2020
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