McLeod Health Clarendon

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

MCLEOD HEALTH CLARENDON

Practice address

10 E Hospital St
Manning, SC 29102-3153

Phone

(803) 435-3523

NPI assigned

Jul 26, 2016

Organization subpart

Yes

Parent organization

MCLEOD HEALTHAs reported in NPPES

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

Authorized official

Name

Samuel Fulton Ervin III

Title

Sr Vice President and Cfo

Phone

(843) 777-2910

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• McLeod EMS and Cypress Transport Doing business as

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551052800000",
    "number": "1669925624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 E HOSPITAL ST",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291023153",
            "telephone_number": "803-435-3523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E HOSPITAL ST",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291023153",
            "telephone_number": "803-435-3523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEOD HEALTH CLARENDON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCLEOD HEALTH",
        "enumeration_date": "2016-07-26",
        "last_updated": "2019-02-25",
        "status": "A",
        "authorized_official_last_name": "ERVIN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "FULTON",
        "authorized_official_title_or_position": "SR VICE PRESIDENT AND CFO",
        "authorized_official_telephone_number": "843-777-2910",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AB0364",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Q596690001",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McLeod EMS and Cypress Transport",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "McLeod EMS and Cypress Transport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• McLeod Health Clarendon
• McLeod Health Clarendon
• McLeod Health Clarendon
• McLeod Health Clarendon
• McLeod Health Clarendon
• McLeod Health Clarendon
• McLeod Health Clarendon LTC Pharmacy
• McLeod Physician Associates II
• McLeod Physician Associates II
• McLeod Physician Associates II

• Ambulance in Manning, SC
• Providers in Manning, SC by specialty
• Ambulance in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2019; 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.