# PREMISE HEALTH OF SOUTH CAROLINA MEDICAL, P.C

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Colonial Life Health Resource Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598200099
- **Authorized official:** JON LEIZMAN MD (PRESIDENT)
- **Authorized official phone:** (216) 479-9063

## Contact information

- **Practice address:** 1200 COLONIAL LIFE BLVD W, COLUMBIA, SC 29210-7670
- **Practice address phone:** (803) 213-6775
- **Practice address fax:** (803) 678-2138
- **Mailing address:** 5500 MARYLAND WAY, SUITE 400, BRENTWOOD, TN 37027-7048

## Taxonomy

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

## Other

- **Enumeration date:** 12/20/2016
- **Last updated:** 08/23/2022