# PROVIDENCE HEALTH NETWORK, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SISTERS OF CHARITY PROVIDENCE HOSPITALS
- **Other names:** Columbia Medical Associates
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1689944738
- **Legal business name:** SISTERS OF CHARITY PROVIDENCE HOSPITALS
- **Authorized official:** MS. ANGELA HAITHCOCK (PROJECT MANAGER)
- **Authorized official phone:** (803) 865-4780

## Contact information

- **Practice address:** 2750 LAUREL ST, SUITE 303, COLUMBIA, SC 29204-2038
- **Practice address phone:** (803) 252-1953
- **Practice address fax:** (803) 256-0138
- **Mailing address:** 114 GATEWAY CORPORATE BLVD, SUITE 425, COLUMBIA, SC 29203-9740
- **Mailing address phone:** (803) 865-4780
- **Mailing address fax:** (803) 865-4932

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/06/2012
- **Last updated:** 01/06/2012