Edisto Regional Health Services Inc., NPI 1003130956
Rural Health Clinic/Center in Bamberg, SC, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1003130956
NPI Entity Type Organization
Provider Name Edisto Regional Health Services Inc.
Doing Business As
Subpart of Organization Edisto Regional Health Services Inc.
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Provider Location Address 498 North Street, Bamberg, SC, US
Provider Mailing Address Po Box 1245, Orangeburg, SC, US, 291161245
Is Sole Proprietor? No
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Organization Official

Official Name MS. Liza Porterfield
Official Position C.F.O.
Phone 803-395-4458

Group Taxonomy

Taxonomy Code 193200000X
Taxonomy Name 193200000X MULTI-SPECIALTY GROUP
Definition A business group of one or more individual practitioners, who practice with different areas of specialization.

Primary Taxonomy

Taxonomy Code

261QR1300X

Taxonomy Name Rural Health Clinic/Center
Classification

Clinic/Center

Group

Ambulatory Health Care Facilities

License No. 19072
License State SC
Description Definition to come...

Other Organization Name

RMC Primary Care Bamberg
Doing Business As

Business Address

Edisto Regional Health Services Inc.
498 North Street

Bamberg, SC, US

Phone: 803-245-5144

Mailing Address

Edisto Regional Health Services Inc.
Po Box 1245
Orangeburg, SC, US
ZIP 291161245
Phone: 803-395-4497
Fax: 803-395-2237

Secondary Taxonomies

Taxonomy Code Group Classification License No. State Primary?

207Q00000X

Allopathic & Osteopathic Physicians

Family Medicine

19072 SC No

207V00000X

Allopathic & Osteopathic Physicians

Obstetrics & Gynecology

22299 SC No

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
CN8991 SC RRMEDICARE 01
019 SC BLUECHOICE 01
017 SC TRICARE 01
GP5405 SC MEDICAID 05
019 SC BCBS 01
RHC199 SC MEDICARE RURAL HEALTH 01
CK8831 SC RRMEDICARE 01

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NPI Name Taxonomy Address

1104473065

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Organization

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OTR/L Sarah Bagley

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Organization

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AGACNP Kaitlin O'sullivan

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D.O Mohamed Mohamed Kelli

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ARNP Pamela Suzanne Harmon

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Lawanna S Carson

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MS. BCBA, COBA Brittany Leigh Fyffe

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PHARMD Taylor Lynn Brown

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1104541515

Katherine Elizabeth Leighton

Individual

Mental Health Counselor

320 Midland Pkwy Ste C

Summerville, SC

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