Provider Demographics
NPI:1881857027
Name:UNIVERSITY OF SOUTH CAROLINA SYSTEM
Entity Type:Organization
Organization Name:UNIVERSITY OF SOUTH CAROLINA SYSTEM
Other - Org Name:UNIVERSITY HEALTH SERVICES CARDIOPULMONARY REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF CARDIOPULMONARY REHAB.
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:V
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:803-313-7104
Mailing Address - Street 1:509 HUBBARD DRIVE
Mailing Address - Street 2:UNIVERSITY OF SC SYSTEM
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720
Mailing Address - Country:US
Mailing Address - Phone:803-313-7104
Mailing Address - Fax:803-313-7194
Practice Address - Street 1:509 HUBBARD DRIVE
Practice Address - Street 2:UNIVERSITY OF SC LANCASTER
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720
Practice Address - Country:US
Practice Address - Phone:803-313-7104
Practice Address - Fax:803-313-7194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCR35052163WC3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC3500XNursing Service ProvidersRegistered NurseCardiac RehabilitationGroup - Single Specialty