# TRIDENT PAIN CENTER P A

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TRIDENT PAIN CENTER LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1104468594
- **Legal business name:** TRIDENT PAIN CENTER LLC
- **Authorized official:** JOSEPH EDWARD NOLAN MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (843) 797-3636

## Contact information

- **Practice address:** 120 HIGHLAND CENTER DR, COLUMBIA, SC 29203-9127
- **Practice address phone:** (843) 797-3636
- **Practice address fax:** (843) 797-3637
- **Mailing address:** 9267 MEDICAL PLAZA DR STE G, NORTH CHARLESTON, SC 29406-9139
- **Mailing address phone:** (843) 797-3636

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/17/2019
- **Last updated:** 03/18/2024