Provider Demographics
NPI:1376840504
Name:HAMPTON REGIONAL MEDICAL CENTER - SWINGBED
Entity type:Organization
Organization Name:HAMPTON REGIONAL MEDICAL CENTER - SWINGBED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:H
Authorized Official - Last Name:HAMILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-943-1251
Mailing Address - Street 1:PO BOX 338
Mailing Address - Street 2:
Mailing Address - City:VARNVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29944
Mailing Address - Country:US
Mailing Address - Phone:803-943-2771
Mailing Address - Fax:803-943-1208
Practice Address - Street 1:595 W. CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:VARNVILLE
Practice Address - State:SC
Practice Address - Zip Code:29944
Practice Address - Country:US
Practice Address - Phone:803-943-2771
Practice Address - Fax:803-943-1208
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAMPTON REGIONAL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-24
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHTL-027275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC42U072Medicare PIN
SC366823Medicaid