CCN: 420020 NPI: 1982604021 Organization

TIDELANDS HEALTH

606 BLACK RIVER RD
GEORGETOWN, SC 294403304

Contact Information

Phone 8435277000
Enumeration Date 2005-07-29
Last Updated 2026-02-12

Taxonomies

Code: 261QM1300X
Code: 282N00000X (Primary) License State: SC License: HTL-0007

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 3

cbsaActualGeographicLocation 42

providerType 07

caseMixIndex 0.7328

operatingCostToChargeRatio 0.299

medicaidRatio 0.1263

uncompensatedCareAmount 2090.31

internsToBedsRatio 0.0038

vbpAdjustment 0.9908324817

hhrAdjustment 0.9949

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.299

medicaidRatio 0.1263

uncompensatedCareAmount 2090.31

internsToBedsRatio 0.0038

vbpAdjustment 0.9908324817

hhrAdjustment 0.9949

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.299

medicaidRatio 0.1263

uncompensatedCareAmount 2090.31

internsToBedsRatio 0.0038

vbpAdjustment 0.9908324817

hhrAdjustment 0.9949

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.299

medicaidRatio 0.1263

uncompensatedCareAmount 1409.08

internsToBedsRatio 0.0038

vbpAdjustment 0.9829832404

hhrAdjustment 0.9928

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.238

medicaidRatio 0.1318

uncompensatedCareAmount 1409.08

internsToBedsRatio 0.0027

vbpAdjustment 0.9829832404

hhrAdjustment 0.9928

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.238

medicaidRatio 0.1318

uncompensatedCareAmount 1409.08

internsToBedsRatio 0.0027

vbpAdjustment 0.9829832404

hhrAdjustment 0.9928

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.238

medicaidRatio 0.1318

uncompensatedCareAmount 1409.08

internsToBedsRatio 0.0038

vbpAdjustment 0.9829832404

hhrAdjustment 0.9928

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.238

medicaidRatio 0.1318

uncompensatedCareAmount 1496.72

internsToBedsRatio 0.0038

vbpAdjustment 0.9984274712

hhrAdjustment 0.9905

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.255

medicaidRatio 0.1211

uncompensatedCareAmount 1496.72

internsToBedsRatio 0.0057

vbpAdjustment 0.9984274712

hhrAdjustment 0.9905

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.255

medicaidRatio 0.1211

uncompensatedCareAmount 1496.72

internsToBedsRatio 0.0057

vbpAdjustment 0.9984274712

hhrAdjustment 0.9905

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.255

medicaidRatio 0.1211

uncompensatedCareAmount 1496.72

internsToBedsRatio 0.0057

vbpAdjustment 0.9984274712

hhrAdjustment 0.9905

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.255

medicaidRatio 0.1211

uncompensatedCareAmount 1513.8

internsToBedsRatio 0.0057

hhrAdjustment 0.9957

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.255

medicaidRatio 0.1261

uncompensatedCareAmount 1513.8

internsToBedsRatio 0.0088

hhrAdjustment 0.9957

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.227

medicaidRatio 0.1261

uncompensatedCareAmount 1513.8

internsToBedsRatio 0.0088

hhrAdjustment 0.9957

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.227

medicaidRatio 0.1261

uncompensatedCareAmount 1513.8

internsToBedsRatio 0.0088

hhrAdjustment 0.9957

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.227

medicaidRatio 0.1261

uncompensatedCareAmount 1513.8

internsToBedsRatio 0.0088

hhrAdjustment 0.9957

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.227

medicaidRatio 0.1261

uncompensatedCareAmount 1513.8

internsToBedsRatio 0.0088

hhrAdjustment 0.9957

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.227

medicaidRatio 0.1261

uncompensatedCareAmount 1559.31

internsToBedsRatio 0.0088

hhrAdjustment 0.9953

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.227

medicaidRatio 0.1585

uncompensatedCareAmount 1559.31

internsToBedsRatio 0.0088

hhrAdjustment 0.9953

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.222

medicaidRatio 0.1585

uncompensatedCareAmount 1559.31

internsToBedsRatio 0.0088

hhrAdjustment 0.9953

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.222

medicaidRatio 0.1585

uncompensatedCareAmount 1559.31

internsToBedsRatio 0.0088

hhrAdjustment 0.9953

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.222

medicaidRatio 0.1585

uncompensatedCareAmount 1559.31

internsToBedsRatio 0.0088

hhrAdjustment 0.9953

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.222

medicaidRatio 0.1585

uncompensatedCareAmount 1559.31

internsToBedsRatio 0.0088

hhrAdjustment 0.9953

censusDivision 3

cbsaActualGeographicLocation 42

providerType 15

caseMixIndex 0.7328

operatingCostToChargeRatio 0.222

medicaidRatio 0.1585

uncompensatedCareAmount 2024.89

internsToBedsRatio 0.0088

vbpAdjustment 0.9923496142

hhrAdjustment 0.9928

censusDivision 3

cbsaActualGeographicLocation 42

providerType 07

caseMixIndex 0.7328

operatingCostToChargeRatio 0.222

medicaidRatio 0.1585

uncompensatedCareAmount 2024.89

internsToBedsRatio 0.0088

vbpAdjustment 0.9923496142

hhrAdjustment 0.9928

censusDivision 3

cbsaActualGeographicLocation 42

providerType 07

caseMixIndex 0.7328

operatingCostToChargeRatio 0.222

medicaidRatio 0.1791

uncompensatedCareAmount 2024.89

internsToBedsRatio 0.0026

vbpAdjustment 0.9923496142

hhrAdjustment 0.9928

censusDivision 3

cbsaActualGeographicLocation 42

providerType 07

caseMixIndex 0.7328

operatingCostToChargeRatio 0.209

medicaidRatio 0.1791

uncompensatedCareAmount 2024.89

internsToBedsRatio 0.0026

vbpAdjustment 0.9923496142

hhrAdjustment 0.9928

censusDivision 3

cbsaActualGeographicLocation 42

providerType 07

caseMixIndex 0.7328

operatingCostToChargeRatio 0.209

medicaidRatio 0.1791

uncompensatedCareAmount 2024.89

internsToBedsRatio 0.0026

vbpAdjustment 0.9923496142

hhrAdjustment 0.9928

censusDivision 3

cbsaActualGeographicLocation 42

providerType 07

caseMixIndex 0.7328

operatingCostToChargeRatio 0.248

medicaidRatio 0.1791

uncompensatedCareAmount 2021.22

internsToBedsRatio 0.0026

vbpAdjustment 0.9923496142

hhrAdjustment 0.9928

censusDivision 3

cbsaActualGeographicLocation 42

providerType 07

caseMixIndex 0.7328

operatingCostToChargeRatio 0.248

medicaidRatio 0.1791

uncompensatedCareAmount 1868.36

internsToBedsRatio 0.0026

vbpAdjustment 1.0043172766

hhrAdjustment 0.9971

censusDivision 3

cbsaActualGeographicLocation 42

providerType 07

caseMixIndex 0.7328

operatingCostToChargeRatio 0.248

medicaidRatio 0.1913

uncompensatedCareAmount 1868.36

vbpAdjustment 1.0043172766

hhrAdjustment 0.9971

censusDivision 3

cbsaActualGeographicLocation 42

providerType 07

caseMixIndex 0.7328

operatingCostToChargeRatio 0.248

medicaidRatio 0.1913

uncompensatedCareAmount 1868.36

vbpAdjustment 1.0043172766

hhrAdjustment 0.9971

censusDivision 3

cbsaActualGeographicLocation 42

providerType 07

caseMixIndex 0.7328

operatingCostToChargeRatio 0.248

medicaidRatio 0.1913

uncompensatedCareAmount 1868.36

vbpAdjustment 1.0043172766

hhrAdjustment 0.9971

censusDivision 3

cbsaActualGeographicLocation 42

providerType 07

caseMixIndex 0.7328

operatingCostToChargeRatio 0.248

medicaidRatio 0.1913

uncompensatedCareAmount 1332.14

vbpAdjustment 0.9973501361

hhrAdjustment 0.9967

censusDivision 3

cbsaActualGeographicLocation 42

providerType 07

caseMixIndex 0.7328

operatingCostToChargeRatio 0.259

medicaidRatio 0.1956

uncompensatedCareAmount 1332.14

vbpAdjustment 0.9973501361

hhrAdjustment 0.9967

censusDivision 3

cbsaActualGeographicLocation 42

providerType 07

caseMixIndex 0.7328

operatingCostToChargeRatio 0.259

medicaidRatio 0.1956

uncompensatedCareAmount 1332.14

vbpAdjustment 0.9973501361

hhrAdjustment 0.9967

censusDivision 3

cbsaActualGeographicLocation 42

providerType 07

caseMixIndex 0.7328

operatingCostToChargeRatio 0.259

medicaidRatio 0.1956

uncompensatedCareAmount 1332.14

vbpAdjustment 0.9973501361

hhrAdjustment 0.9967

censusDivision 3

cbsaActualGeographicLocation 42

providerType 07

caseMixIndex 0.7328

operatingCostToChargeRatio 0.259

medicaidRatio 0.1956

uncompensatedCareAmount 1332.14

vbpAdjustment 0.9973501361

hhrAdjustment 0.9967

censusDivision 3

cbsaActualGeographicLocation 42

providerType 07

caseMixIndex 0.7328

operatingCostToChargeRatio 0.259

medicaidRatio 0.1956

uncompensatedCareAmount 867.48

vbpAdjustment 1.0087883983

hhrAdjustment 0.9971

censusDivision 3

cbsaActualGeographicLocation 42

providerType 07

caseMixIndex 0.7328

operatingCostToChargeRatio 0.259

medicaidRatio 0.1874

uncompensatedCareAmount 867.48

vbpAdjustment 1.0087883983

hhrAdjustment 0.9971

censusDivision 3

cbsaActualGeographicLocation 42

providerType 07

caseMixIndex 0.7328

operatingCostToChargeRatio 0.248

medicaidRatio 0.1874

uncompensatedCareAmount 867.48

vbpAdjustment 1.0087883983

hhrAdjustment 0.9971

Outpatient Payment Attributes (OPSF) View Dictionary →

Effective Date:

cbsaActualGeographicLocation 42

providerType 07

operatingCostToChargeRatio 0.31

deviceCostToChargeRatio 0.936

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

cbsaActualGeographicLocation 42

providerType 07

operatingCostToChargeRatio 0.31

deviceCostToChargeRatio 0.936

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

cbsaActualGeographicLocation 42

providerType 07

operatingCostToChargeRatio 0.31

deviceCostToChargeRatio 0.936

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

cbsaActualGeographicLocation 42

providerType 07

operatingCostToChargeRatio 0.233

deviceCostToChargeRatio 0.828

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

cbsaActualGeographicLocation 42

providerType 07

operatingCostToChargeRatio 0.233

deviceCostToChargeRatio 0.828

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

cbsaActualGeographicLocation 42

providerType 07

operatingCostToChargeRatio 0.224

deviceCostToChargeRatio 0.327

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

cbsaActualGeographicLocation 42

providerType 07

operatingCostToChargeRatio 0.224

deviceCostToChargeRatio 0.327

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

cbsaActualGeographicLocation 42

providerType 07

operatingCostToChargeRatio 0.216

deviceCostToChargeRatio 0.313

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

cbsaActualGeographicLocation 42

providerType 07

operatingCostToChargeRatio 0.216

deviceCostToChargeRatio 0.313

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

cbsaActualGeographicLocation 42

providerType 15

operatingCostToChargeRatio 0.216

deviceCostToChargeRatio 0.313

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

cbsaActualGeographicLocation 42

providerType 15

operatingCostToChargeRatio 0.22

deviceCostToChargeRatio 0.308

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

cbsaActualGeographicLocation 42

providerType 15

operatingCostToChargeRatio 0.22

deviceCostToChargeRatio 0.308

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

cbsaActualGeographicLocation 42

providerType 07

operatingCostToChargeRatio 0.22

deviceCostToChargeRatio 0.308

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

cbsaActualGeographicLocation 42

providerType 07

operatingCostToChargeRatio 0.205

deviceCostToChargeRatio 0.329

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

cbsaActualGeographicLocation 42

providerType 07

operatingCostToChargeRatio 0.205

deviceCostToChargeRatio 0.329

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

cbsaActualGeographicLocation 42

providerType 07

operatingCostToChargeRatio 0.211

deviceCostToChargeRatio 0.314

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

cbsaActualGeographicLocation 42

providerType 07

operatingCostToChargeRatio 0.211

deviceCostToChargeRatio 0.314

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

cbsaActualGeographicLocation 42

providerType 07

operatingCostToChargeRatio 0.196

deviceCostToChargeRatio 0.316

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

cbsaActualGeographicLocation 42

providerType 07

operatingCostToChargeRatio 0.196

deviceCostToChargeRatio 0.316

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

cbsaActualGeographicLocation 42

providerType 07

operatingCostToChargeRatio 0.196

deviceCostToChargeRatio 0.316

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 11202

localityCode 01

TIDELANDS HEALTH

Contact Information

Taxonomies

Inpatient Payment Attributes (IPSF) View Dictionary →

Outpatient Payment Attributes (OPSF) View Dictionary →

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