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Organization

MONCRIEF ARMY COMMUNITY HOSPITAL

Active
Parent organization
MONCRIEF ARMY COMMUNITY HOSPITAL
Other names
CBMH MONCRIEF-JACKSON
Organization subpart
Yes

Provider details

NPI number
Legal business name
MONCRIEF ARMY COMMUNITY HOSPITAL
Authorized official
WILLIE WARREN (CHIEF, UBO)
(803) 751-0472
Entity
Organization

Contact information

Practice address
1021 PINNANCLE POINT, MONCRIEF MEDICAL HOME-JACKSON, COLUMBIA, SC 29223-5740
(803) 751-6971
Mailing address
4500 STUART ST, BOX 497 - BILLING OFFICE, COLUMBIA, SC 29207-5700
(803) 751-0472

Taxonomy

Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1386652956
PARENT FACILITY NPI 2
Enumeration date
06/03/2010
Last updated
04/08/2015
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