Provider Demographics
NPI:1164496527
Name:THE REGIONAL MEDICAL CENTER OF ORANGEBURG AND CALHOUN COUNTIES
Entity Type:Organization
Organization Name:THE REGIONAL MEDICAL CENTER OF ORANGEBURG AND CALHOUN COUNTIES
Other - Org Name:ORANGEBURG SURGICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.F.O.
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:S
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-395-2224
Mailing Address - Street 1:PO BOX 1245
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29116-1245
Mailing Address - Country:US
Mailing Address - Phone:803-395-4497
Mailing Address - Fax:803-536-0998
Practice Address - Street 1:1175 COOK RD STE 320
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-8247
Practice Address - Country:US
Practice Address - Phone:803-536-2555
Practice Address - Fax:803-531-6414
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE REGIONAL MEDICAL CENTER OF ORANGEBURG AND CALHOUN COUNTIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-14
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC012OtherBCBS
SCGP3518Medicaid
SC012OtherBCBS