NPIMap

Organization Active NPI

Georgetown Health Group

Doing business as Medical Building, PA

  • Primary Care Clinic/Center
  • Georgetown, SC
National Provider Identifier
1255483327
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
GEORGETOWN HEALTH GROUP
Doing business as
Medical Building, PA
Practice address
1530 Highmarket St
Georgetown, SC 29440-3121
Phone
(843) 546-5128
Fax
(843) 527-7500
NPI assigned
Jan 17, 2007
Last updated
Nov 26, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amanda Wright
Title
Vice Administrator
Phone
(843) 527-4442

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1530 Highmarket St
Georgetown, SC 29440-3121

Mailing address

1075 N Fraser St
Georgetown, SC 29440-2848
Phone (843) 527-4442

Other identifiers 1

IdentifierTypeStateIssuer
GP1371MedicaidSC

Other names 1

  • Medical Building, PA Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Georgetown Health Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196035200000",
    "number": "1255483327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 N FRASER ST",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294402848",
            "telephone_number": "843-527-4442",
            "fax_number": "843-527-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 HIGHMARKET ST",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294403121",
            "telephone_number": "843-546-5128",
            "fax_number": "843-527-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGETOWN HEALTH GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-11-26",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "VICE ADMINISTRATOR",
        "authorized_official_telephone_number": "843-527-4442"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1371",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Building, PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Georgetown, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.