# PALMETTO HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PALMETTO HEALTH ALLIANCE
- **Other names:** Medical Park Pediatrics
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1871538397
- **Legal business name:** PALMETTO HEALTH ALLIANCE
- **Authorized official:** DARRELL C COVEN (DIRECTOR OF BUSINESS DEV., FINANCE)
- **Authorized official phone:** (803) 296-7301

## Contact information

- **Practice address:** 1316 N LAKE DR, LEXINGTON, SC 29072-7653
- **Practice address phone:** (803) 296-7304
- **Practice address fax:** (803) 296-7329
- **Mailing address:** PO BOX 402145, ATLANTA, GA 30384-2145
- **Mailing address phone:** (803) 296-7313
- **Mailing address fax:** (803) 296-7330

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | Yes |
| 208000000X | Pediatrics Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/18/2006
- **Last updated:** 12/27/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP2275 | — | SC |