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Organization
PALMETTO HEALTH
Active
Organization
PALMETTO HEALTH
Active
Parent organization
PALMETTO HEALTH
Other names
ColoRectal Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
PALMETTO HEALTH
Authorized official
DARRELL C COVEN (DIRECTOR, AMBULATORY SVCS - FINANCE)
(803) 296-7301
Entity
Organization
Contact information
Practice address
1333 TAYLOR ST, SUITE 5-F, COLUMBIA, SC 29201-2923
(803) 748-9966
(803) 748-7174
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7305
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
NULL
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP5354
—
SC
Enumeration date
01/14/2010
Last updated
07/03/2015
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