Provider Demographics
NPI:1013996867
Name:COUNTY OF ABBEVILLE OF COMMISSIONERS
Entity Type:Organization
Organization Name:COUNTY OF ABBEVILLE OF COMMISSIONERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MADDOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-366-2400
Mailing Address - Street 1:PO BOX 84278
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-0005
Mailing Address - Country:US
Mailing Address - Phone:803-957-7111
Mailing Address - Fax:803-957-7115
Practice Address - Street 1:903 W GREENWOOD ST STE 1400
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29620-5660
Practice Address - Country:US
Practice Address - Phone:864-366-2400
Practice Address - Fax:864-366-4608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-11
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAB0202Medicaid
SCAB0202Medicaid