Provider Demographics
NPI:1972939957
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:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JOBERT
Authorized Official - Middle Name:ARAGON
Authorized Official - Last Name:VEGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-395-4497
Mailing Address - Street 1:PO BOX 1245
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29116-1245
Mailing Address - Country:US
Mailing Address - Phone:803-395-4497
Mailing Address - Fax:803-395-2237
Practice Address - Street 1:2850 PELHAM CT
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-1400
Practice Address - Country:US
Practice Address - Phone:803-395-3737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-23
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7389Medicare PIN