Provider Demographics
NPI:1083663553
Name:AIKEN REGIONAL MEDICAL CENTERS
Entity Type:Organization
Organization Name:AIKEN REGIONAL MEDICAL CENTERS
Other - Org Name:AIKEN REGIONAL MEDICAL CENTERS CRNAS/PSYCHIATRIST/INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:MARY NELL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-883-5830
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:SULLIVANS IS
Mailing Address - State:SC
Mailing Address - Zip Code:29482-0040
Mailing Address - Country:US
Mailing Address - Phone:843-883-5830
Mailing Address - Fax:843-883-5829
Practice Address - Street 1:302 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-6302
Practice Address - Country:US
Practice Address - Phone:803-641-5622
Practice Address - Fax:803-641-5625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP3656Medicaid
SCGP3656Medicaid