Provider Demographics
NPI:1588858401
Name:BAMBERG COUNTY HOSPITAL & NURSING CENTER
Entity Type:Organization
Organization Name:BAMBERG COUNTY HOSPITAL & NURSING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HAMMETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-245-6228
Mailing Address - Street 1:509 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:BAMBERG
Mailing Address - State:SC
Mailing Address - Zip Code:29003-1330
Mailing Address - Country:US
Mailing Address - Phone:803-245-4321
Mailing Address - Fax:803-245-6213
Practice Address - Street 1:509 NORTH ST
Practice Address - Street 2:
Practice Address - City:BAMBERG
Practice Address - State:SC
Practice Address - Zip Code:29003-1330
Practice Address - Country:US
Practice Address - Phone:803-245-4321
Practice Address - Fax:803-245-6213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC377956261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC400569Medicaid
SC166383Medicaid
SC401847Medicaid
SC400569Medicaid
SC401847Medicaid