# PRISMA HEALTH-UPSTATE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Prisma Health Laurens Family Med-Main
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659051464
- **Authorized official:** POLLY H MILLER (SVP FINANCE, ENTERPRISE CONTRACTING)
- **Authorized official phone:** (864) 522-2286

## Contact information

- **Practice address:** 106 PARKVIEW DR, LAURENS, SC 29360-2652
- **Practice address phone:** (864) 984-0571
- **Practice address fax:** (864) 984-3610
- **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