NPIMap

Organization Active NPI

Peedeehealthcare

  • Clinical Medical Laboratory
  • Darlington, SC
National Provider Identifier
1265643134
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PEEDEEHEALTHCARE
Practice address
201 Cashua St
Darlington, SC 29532-3301
Phone
(843) 393-7452
Fax
(843) 393-6210
NPI assigned
May 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Cheri Reed
Title
Accounting Manager
Phone
(803) 799-1700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X SC Primary

Addresses

Primary practice location

201 Cashua St
Darlington, SC 29532-3301

Mailing address

3400 West Ave
Columbia, SC 29203-6901
Phone (803) 799-1700

Other identifiers 3

IdentifierTypeStateIssuer
L00047MedicaidSC
IC0007MedicaidSC
PA6118MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
DME5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

3400 West Ave
Columbia, SC 29203
Phone (803) 799-1700

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265643134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 WEST AVE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036901",
            "telephone_number": "803-799-1700",
            "fax_number": "803-254-3678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CASHUA ST",
            "city": "DARLINGTON",
            "state": "SC",
            "postal_code": "295323301",
            "telephone_number": "843-393-7452",
            "fax_number": "843-393-6210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEEDEEHEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "CHERI",
        "authorized_official_title_or_position": "ACCOUNTING MANAGER",
        "authorized_official_telephone_number": "803-799-1700"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L00047",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IC0007",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA6118",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Darlington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.