NPIMap

Organization Active NPI

Kershaw Hospital LLC

  • Infusion Therapy Clinic/Center
  • Camden, SC
National Provider Identifier
1588737498
Registry record updated Sep 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X
Legal business name
KERSHAW HOSPITAL LLC
Practice address
1315 Roberts St
Camden, SC 29020-3737
Phone
(803) 713-6376
NPI assigned
Nov 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2016

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

Authorized official

Name
Mr. Michael A Wiechart
Title
President and Ceo
Phone
(615) 844-9800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Clinic/Center 261QI0500X SC Primary

Addresses

Primary practice location

1315 Roberts St
Camden, SC 29020-3737

Mailing address

PO Box 7003
Camden, SC 29020-7003
Phone (803) 713-6376

Other identifiers 2

IdentifierTypeStateIssuer
IC0031MedicaidSC
42D0248614OtherSCCLIA#

National Provider Directory

National Provider Directory
Tax ID family
Kershaw Hospital LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473984000000",
    "number": "1588737498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7003",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290207003",
            "telephone_number": "803-713-6376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 ROBERTS ST",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290203737",
            "telephone_number": "803-713-6376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERSHAW HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2016-09-16",
        "status": "A",
        "authorized_official_last_name": "WIECHART",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "615-844-9800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IC0031",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA#",
            "identifier": "42D0248614",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; 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.