Provider Demographics
NPI:1740604453
Name:ORANGEBURG CO. DSN BOARD
Entity Type:Organization
Organization Name:ORANGEBURG CO. DSN BOARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:LOFTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-536-1170
Mailing Address - Street 1:PO BOX 1812
Mailing Address - Street 2:2785 E. MAGNOLIA
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29116-1812
Mailing Address - Country:US
Mailing Address - Phone:803-536-1170
Mailing Address - Fax:
Practice Address - Street 1:2785 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29115-2502
Practice Address - Country:US
Practice Address - Phone:803-536-1170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-17
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare