Provider Demographics
NPI:1821026816
Name:EAST COOPER COMMUNITY HOSPITAL, INC.
Entity Type:Organization
Organization Name:EAST COOPER COMMUNITY HOSPITAL, INC.
Other - Org Name:EAST COOPER MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:HEATH
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-416-6215
Mailing Address - Street 1:PO BOX 741267
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-1267
Mailing Address - Country:US
Mailing Address - Phone:843-881-0100
Mailing Address - Fax:843-416-6886
Practice Address - Street 1:2000 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3764
Practice Address - Country:US
Practice Address - Phone:843-881-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC447282N00000X
341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC40089AMedicaid
231641230OtherAETNA US HEALTHCARE (NATI
199669500OtherDEPARTMENT OF LABOR
SC40089BMedicaid
420089B000000OtherSECTION 1011
SC40089AMedicaid