| NPI | 1114128824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYN FLETCHER VAN DAM Physician 803-296-3304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: SC 22508) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2008-09-10 |