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Organization

EDISTO REGIONAL HEALTH SERVICES INC.

Active
Parent organization
EDISTO REGIONAL HEALTH SERVICES INC.
Other names
RMC Primary Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
EDISTO REGIONAL HEALTH SERVICES INC.
Authorized official
CHERYL S MASON (CFO)
(803) 395-2224
Entity
Organization

Contact information

Practice address
3000 SAINT MATTHEWS RD, ORANGEBURG, SC 29118-1442
(803) 395-2576
(803) 536-5220
Mailing address
PO BOX 1245, ORANGEBURG, SC 29116-1245
(803) 395-4762
(803) 536-0998

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
261QR1300X
Rural Health Clinic/Center
Primary
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007
BCBS
SC
01
42-3880
MEDICAID RHC
SC
01
CK8831
RRMEDICARE
SC
01
CN8991
RRMEDICARE
SC
05
GP4350
SC
Enumeration date
01/27/2011
Last updated
12/03/2012
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