Provider Demographics
NPI:1922063858
Name:THE REGIONAL MEDICAL CENTER OF ORANGEBURG AND CALHOUN COUNTIES
Entity Type:Organization
Organization Name:THE REGIONAL MEDICAL CENTER OF ORANGEBURG AND CALHOUN COUNTIES
Other - Org Name:SC ORTHOPAEDIC INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SOLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-531-0126
Mailing Address - Street 1:PO BOX 1245
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29116-1245
Mailing Address - Country:US
Mailing Address - Phone:803-395-4497
Mailing Address - Fax:803-395-2237
Practice Address - Street 1:1175 COOK RD
Practice Address - Street 2:SUITE 215
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-8201
Practice Address - Country:US
Practice Address - Phone:803-531-0126
Practice Address - Fax:803-536-5122
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE REGIONAL MEDICAL CENTER OF ORANGEBURG AND CALHOUN COUNTIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-20
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19837204C00000X
SCDE2770332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP3618Medicaid
SCDE2770OtherMEDICAID DME
SC1245880002Medicare NSC
SC7496Medicare UPIN