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Organization

CHESTERFIELD-MARLBORO LP

Active
Parent organization
CHESTERFIELD-MARLBORO LP
Other names
Marlboro Park Hospital
Organization subpart
Yes

Provider details

NPI number
Legal business name
CHESTERFIELD-MARLBORO LP
Authorized official
DEBBIE BREWER (DIRECTOR)
(877) 892-9813
Entity
Organization

Contact information

Practice address
1138 CHERAW HWY, BENNETTSVILLE, SC 29512-2466
(843) 454-8400
(843) 479-5860
Mailing address
PO BOX 689022, PROVIDER ENROLLMENT DEPARTMENT, FRANKLIN, TN 37068-9022
(888) 304-1079
(615) 469-6629

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
SC
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
207RC0000X
Cardiovascular Disease Physician
367500000X
Certified Registered Nurse Anesthetist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
203749
UNISON
SC
05
400541
SC
05
5916149
NC
05
8053756
NC
Enumeration date
07/08/2010
Last updated
11/18/2011
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