Clarendon Memorial Hospital – Home Health Agency

Key facts

NPI: 1376628875
Entity type: Organization (NPI type 2)
Primary specialty: Home Health Agency 251E00000X
License: HHA 141 (SC)
Legal business name: CLARENDON MEMORIAL HOSPITAL
Practice address: 23 S Mill St
Manning, SC 29102-3167
Phone: (803) 435-4494
Fax: (803) 435-3196
NPI assigned: Oct 25, 2006
Organization subpart: No

Authorized official

Name: Mr. Richard W Stokes
Title: Chief Financial Officer
Phone: (803) 435-8463

National Provider Directory

Locations

23 S Mill St
Manning, SC 29102
Phone (803) 435-4494

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Home Health Agency	251E00000X	HHA 141	SC	Yes

Addresses

Primary practice location

23 S Mill St
Manning, SC 29102-3167

Mailing address

23 S Mill St
Manning, SC 29102-3167
Phone (803) 435-4494

Other identifiers

Identifier	Type	State	Issuer
471085	Medicaid	SC

Other names

Clarendon Memorial Home Health Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 26, 2009.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245974400000",
    "number": "1376628875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 S MILL ST",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291023167",
            "telephone_number": "803-435-4494",
            "fax_number": "803-435-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 S MILL ST",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291023167",
            "telephone_number": "803-435-4494",
            "fax_number": "803-435-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARENDON MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2009-06-26",
        "status": "A",
        "authorized_official_last_name": "STOKES",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "803-435-8463",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "SC",
            "license": "HHA 141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "471085",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarendon Memorial Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manning, SC

All providers in Manning, SC · Home Health Agency in South Carolina

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2009. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.