# PRISMA HEALTH-UPSTATE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Prisma Health Diabetes Self Care Mgt Prog
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285180307
- **Authorized official:** POLLY H. MILLER (VP PAYOR STRATEGIES & ALIGNMENT)
- **Authorized official phone:** (864) 522-2286

## Contact information

- **Practice address:** 875 W FARIS RD, GREENVILLE, SC 29605-4254
- **Practice address phone:** (864) 455-4003
- **Mailing address:** 300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
- **Mailing address phone:** (864) 455-7000

## Taxonomy

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

## Other

- **Enumeration date:** 08/29/2016
- **Last updated:** 06/14/2023
