Provider Demographics
NPI:1548270507
Name:WILLIAM ARTHUR JONES MIDLANDS HEALTH CENTER
Entity type:Organization
Organization Name:WILLIAM ARTHUR JONES MIDLANDS HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE DEPARTMENT
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BENEDICT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-252-2255
Mailing Address - Street 1:3106 DEVINE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-1846
Mailing Address - Country:US
Mailing Address - Phone:803-252-2255
Mailing Address - Fax:803-252-5436
Practice Address - Street 1:3106 DEVINE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-1846
Practice Address - Country:US
Practice Address - Phone:803-252-2255
Practice Address - Fax:803-252-5436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC8167OtherPTAN
SC5843620001Medicare NSC