Provider Demographics
NPI:1497985162
Name:BARNWELL COUNTY HOSPITAL
Entity Type:Organization
Organization Name:BARNWELL COUNTY HOSPITAL
Other - Org Name:WILLISTON FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:H
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-541-4173
Mailing Address - Street 1:45 ROUNDTREE ST
Mailing Address - Street 2:PO BOX 177
Mailing Address - City:WILLISTON
Mailing Address - State:SC
Mailing Address - Zip Code:29853-2303
Mailing Address - Country:US
Mailing Address - Phone:803-266-3600
Mailing Address - Fax:803-266-3641
Practice Address - Street 1:45 ROUNDTREE ST
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:SC
Practice Address - Zip Code:29853-2303
Practice Address - Country:US
Practice Address - Phone:803-266-3600
Practice Address - Fax:803-266-3641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC42-3437Medicare PIN