Provider Demographics
NPI:1942259221
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:HOME CARE OF THE REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:JOBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:VEGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-395-4497
Mailing Address - Street 1:1895 SAINT MATTHEWS RD
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-2403
Mailing Address - Country:US
Mailing Address - Phone:803-395-2600
Mailing Address - Fax:
Practice Address - Street 1:1175 COOK RD STE 325
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-8247
Practice Address - Country:US
Practice Address - Phone:803-395-2600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE REGIONAL MEDICAL CENTER OF ORANGEBURG AND CALHOUN COUNTIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-06
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHHA122251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPP0012Medicaid
SC427110Medicaid
SCPP0012Medicaid