Provider Demographics
NPI:1376597997
Name:WALTERBORO COMMUNITY HOSPITAL, INC.
Entity Type:Organization
Organization Name:WALTERBORO COMMUNITY HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-782-2602
Mailing Address - Street 1:501 ROBERTSON BLVD
Mailing Address - Street 2:
Mailing Address - City:WALTERBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29488-2787
Mailing Address - Country:US
Mailing Address - Phone:843-782-2000
Mailing Address - Fax:843-549-0246
Practice Address - Street 1:501 ROBERTSON BLVD
Practice Address - Street 2:
Practice Address - City:WALTERBORO
Practice Address - State:SC
Practice Address - Zip Code:29488-2787
Practice Address - Country:US
Practice Address - Phone:843-782-2000
Practice Address - Fax:843-549-0246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ029456Medicaid
TX072793501Medicaid
IN200228330AMedicaid
MD281455200Medicaid
SC324008Medicaid
NY1707597Medicaid
NC4200030Medicaid
420030OtherHIGHMARK BC
MS05776536Medicaid
LA1729051Medicaid
FL94441600Medicaid
KY1600352Medicaid
ME431914100Medicaid
GA00504061XMedicaid
OH0761715Medicaid
154901000OtherDEPT OF LABOR
FL284106OtherAVMED
NJ0048607Medicaid
ALCOL0030NMedicaid
GA00504061XMedicaid