Organization
CANNON MEMORIAL HOSPITAL
Active
Parent organization
CANNON MEMORIAL HOSPITAL
Other names
Cannon Family Practice - Eastside
Organization subpart
Yes
Provider details
NPI number
Legal business name
CANNON MEMORIAL HOSPITAL
Authorized official
MR. NORMAN GENE RENTZ (CEO)
(864) 878-4791
Entity
Organization
Contact information
Practice address
111 W. ROPER RD., EASLEY, SC 29640
(864) 897-8280
(864) 897-8281
Mailing address
PO BOX 919, PICKENS, SC 29671-0919
(864) 897-8286
(864) 897-8281
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4650
—
SC
Enumeration date
06/06/2007
Last updated
07/20/2010
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