Mid-Carolina Hospital Group, LLC

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

HTL897 Issued in SC

Legal business name

MID-CAROLINA HOSPITAL GROUP, LLC

Practice address

258 N Ron McNair Blvd
Lake City, SC 29560-2462

Phone

(843) 374-2036

Fax

(843) 374-5111

NPI assigned

Mar 30, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Tony R Megna, ESQ

Title

Ceo

Phone

(803) 799-1700

Specialties & licenses 1

Addresses

Other names 1

• Lake City Community Hospital Doing business as

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962522326",
    "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": "808-799-1700",
            "fax_number": "803-254-3678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 N RON MCNAIR BLVD",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602462",
            "telephone_number": "843-374-2036",
            "fax_number": "843-374-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-CAROLINA HOSPITAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MEGNA",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "803-799-1700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ESQ"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "SC",
            "license": "HTL897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake City Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Medical University Hospital Authority
• Medical University Hospital Authority
• Medicine Cabinet Clinical Services LLC
• Medicine Cabinet of Lake City
• Medtran Express
• Eliza M Miles, LPN
• Albert D Mims, M.D.
• Mindful Behavioral Inc
• Maud N Mmbo-Keith, OTR/L
• Sergio Montes, PHARMACIST

• All providers in Lake City, SC
• General Acute Care Hospital in South Carolina

• 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.