# COLUMBIA ASC NORTHWEST LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lake Murray Endoscopy Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063486504
- **Authorized official:** MR. PHILLIP CLENDENIN (PRESIDENT)
- **Authorized official phone:** (615) 665-1283

## Contact information

- **Practice address:** 190 PARKRIDGE DR, SUITE 100, COLUMBIA, SC 29212-1747
- **Practice address phone:** (803) 407-6767
- **Practice address fax:** (803) 407-6757
- **Mailing address:** 1A BURTON HILLS BLVD, ATTN: L&C, NASHVILLE, TN 37215-6103
- **Mailing address phone:** (803) 407-6767
- **Mailing address fax:** (803) 407-6757

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | ASF-076 | SC | Yes |

## Other

- **Enumeration date:** 02/13/2006
- **Last updated:** 09/07/2023