Provider Demographics
NPI:1962456053
Name:QHG OF SOUTH CAROLINA INC
Entity Type:Organization
Organization Name:QHG OF SOUTH CAROLINA INC
Other - Org Name:CAROLINAS HOSPITAL SYSTEM-CEDAR TOWER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:LALOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-925-4565
Mailing Address - Street 1:PO BOX 277631
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-7631
Mailing Address - Country:US
Mailing Address - Phone:843-674-2500
Mailing Address - Fax:843-674-2519
Practice Address - Street 1:121 E CEDAR ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2576
Practice Address - Country:US
Practice Address - Phone:843-674-2500
Practice Address - Fax:843-674-2519
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QHG OF SOUTH CAROLINA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-21
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHTL-674273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
42T091Medicare Oscar/Certification