# PALMETTO PEDIATRIC GASTROENTEROLOGY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558320275
- **Authorized official:** DR. RATHNA P. AMARNATH M. D. (PHYSICIAN)
- **Authorized official phone:** (803) 254-1006

## Contact information

- **Practice address:** 2113 ADAMS GRV, SUITE 200, COLUMBIA, SC 29203-7102
- **Practice address phone:** (803) 254-1006
- **Practice address fax:** (803) 254-2090
- **Mailing address:** 2113 ADAMS GRV, SUITE 200, COLUMBIA, SC 29203-7102
- **Mailing address phone:** (803) 254-1006
- **Mailing address fax:** (803) 254-2090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 14383 | SC | Yes |

## Other

- **Enumeration date:** 03/21/2006
- **Last updated:** 05/27/2008