Organization
EDISTO REGIONAL HEALTH SERVICES INC.
Active
Parent organization
EDISTO REGIONAL HEALTH SERVICES INC.
Other names
RMC Primary Care North
Organization subpart
Yes
Provider details
NPI number
Legal business name
EDISTO REGIONAL HEALTH SERVICES INC.
Authorized official
LIZA PORTERFIELD (C F O)
(803) 395-4458
Entity
Organization
Contact information
Practice address
4631 SAVANNAH HIGHWAY, NORTH, SC 29112-8180
(803) 247-2428
(803) 247-2650
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
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009
BCBS
SC
01
—
42-3881
RHC MEDICAID
SC
01
—
CK8831
RRMEDICARE
SC
01
—
CN8991
RRMEDICARE
SC
05
—
GP44779
—
SC
Enumeration date
01/26/2011
Last updated
09/28/2017
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