# STATE OF SOUTH CAROLINA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Appalachia II CRS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467516690
- **Authorized official:** MRS. BETTY H GARREN (DIRECTOR,THIRD PARTY ADMINISTRATION)
- **Authorized official phone:** (803) 898-3720

## Contact information

- **Practice address:** 200 UNIVERSITY RDG, GREENVILLE, SC 29601-3635
- **Practice address phone:** (864) 282-4300
- **Practice address fax:** (864) 282-4372
- **Mailing address:** 1751 CALHOUN ST, COLUMBIA, SC 29201-2606
- **Mailing address phone:** (803) 898-0288
- **Mailing address fax:** (803) 898-0501

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 12/21/2006
- **Last updated:** 05/09/2012