Provider Demographics
NPI:1407022189
Name:UNION HOSPITAL DISTRICT
Entity type:Organization
Organization Name:UNION HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHA DIRECTOR PHYSICIAN SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:TAMI
Authorized Official - Middle Name:C
Authorized Official - Last Name:PETTIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-427-0331
Mailing Address - Street 1:407 W. SOUTH ST. STE. C
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:SC
Mailing Address - Zip Code:29379-2771
Mailing Address - Country:US
Mailing Address - Phone:864-429-8846
Mailing Address - Fax:
Practice Address - Street 1:407 W. SOUTH ST. STE. C
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379-2771
Practice Address - Country:US
Practice Address - Phone:864-429-8846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNION HOSPTIAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-02
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health