Provider Demographics
NPI:1477881126
Name:BAPTIST EASLEY HOSPITAL
Entity Type:Organization
Organization Name:BAPTIST EASLEY HOSPITAL
Other - Org Name:PEDIATRIC TEAM CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LARRY
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-442-7610
Mailing Address - Street 1:1807A EAST MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-0000
Mailing Address - Country:US
Mailing Address - Phone:864-442-7557
Mailing Address - Fax:864-442-7579
Practice Address - Street 1:1807A EAST MAIN ST.
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-0000
Practice Address - Country:US
Practice Address - Phone:864-442-7557
Practice Address - Fax:864-442-7579
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAPTIST EASLEY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-18
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty