Provider Demographics
NPI:1700072444
Name:UNION HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:UNION HOSPITAL DISTRICT
Other - Org Name:CHA CENTER FOR OB/GYN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEANS-LOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-427-2881
Mailing Address - Street 1:720 SOUTH DUNCAN BYPASS
Mailing Address - Street 2:SUITE C
Mailing Address - City:UNION
Mailing Address - State:SC
Mailing Address - Zip Code:29379
Mailing Address - Country:US
Mailing Address - Phone:864-427-2881
Mailing Address - Fax:864-427-2940
Practice Address - Street 1:720 SOUTH DUNCAN BYPASS
Practice Address - Street 2:SUITE C
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379
Practice Address - Country:US
Practice Address - Phone:864-427-2881
Practice Address - Fax:864-427-2940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP4786Medicaid
SCGP4786Medicaid