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Organization
UNION HOSPITAL DISTRICT
Active
Organization
UNION HOSPITAL DISTRICT
Active
Other names
CHA Upstate Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
TAMI C PETTIT (CHA DIRECTOR PHYSICIAN SERVICES)
(864) 427-4081
Entity
Organization
Contact information
Practice address
407 W. SOUTH ST. STE. C, UNION, SC 29379-2771
(864) 429-8846
(864) 429-9093
Mailing address
720 S DUNCAN BYP, UNION, SC 29379-7830
(864) 427-4081
(864) 427-8733
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3026
—
SC
Enumeration date
02/10/2009
Last updated
09/16/2013
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