Provider Demographics
NPI:1740794049
Name:NEWBERRY COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:NEWBERRY COUNTY MEMORIAL HOSPITAL
Other - Org Name:WHITMIREMEDICAL CENTER OF NEWBERRY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-364-2310
Mailing Address - Street 1:2669 KINARD STREET
Mailing Address - Street 2:ATTENTION: PFS DIRECTOR
Mailing Address - City:NEWBERRY
Mailing Address - State:SC
Mailing Address - Zip Code:29108
Mailing Address - Country:US
Mailing Address - Phone:803-405-7136
Mailing Address - Fax:803-405-7196
Practice Address - Street 1:166 MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITMIRE
Practice Address - State:SC
Practice Address - Zip Code:29178-1318
Practice Address - Country:US
Practice Address - Phone:803-805-0153
Practice Address - Fax:803-805-0156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-22
Last Update Date:2017-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty