# PRISMA HEALTH-UPSTATE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Prisma Health Pediatrics-Seneca
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215617097
- **Authorized official:** POLLY H MILLER (SVP FINANCE, ENTERPRISE CONTRACTING)
- **Authorized official phone:** (864) 522-2286

## Contact information

- **Practice address:** 109 OMNI DR STE B, SENECA, SC 29672-9448
- **Practice address phone:** (864) 888-4222
- **Practice address fax:** (864) 888-0023
- **Mailing address:** 300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842

## 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