Provider Demographics
NPI:1629442397
Name:KERSHAW HOSPITAL LLC
Entity Type:Organization
Organization Name:KERSHAW HOSPITAL LLC
Other - Org Name:KERSHAWHEALTH URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTEP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-764-3000
Mailing Address - Street 1:40 PINNACLE PKWY
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-8390
Mailing Address - Country:US
Mailing Address - Phone:803-424-8020
Mailing Address - Fax:803-424-8085
Practice Address - Street 1:40 PINNACLE PKWY
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:SC
Practice Address - Zip Code:29045-8390
Practice Address - Country:US
Practice Address - Phone:803-424-8020
Practice Address - Fax:803-424-8085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty