# PRISMA HEALTH-UPSTATE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Prisma Health Laurens Family Med-Gray Ct
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194405969
- **Authorized official:** POLLY H. MILLER (SVP FIN ENTERPRISE CONTRACTING)
- **Authorized official phone:** (864) 522-2286

## Contact information

- **Practice address:** 9100 HIGHWAY 14, GRAY COURT, SC 29645-4152
- **Practice address phone:** (864) 522-2286
- **Mailing address:** 300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
- **Mailing address phone:** (864) 522-2286

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/18/2023
- **Last updated:** 10/12/2023