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Organization
PALMETTO HEALTH
Active
Organization
PALMETTO HEALTH
Active
Parent organization
PALMETTO HEALTH
Other names
Palmetto Health Ophthalmology
Organization subpart
Yes
Provider details
NPI number
Legal business name
PALMETTO HEALTH
Authorized official
MR. DARRELL C COVEN (DIRECTOR-AMBULATORY SRVCS-FINANCE)
(803) 296-7301
Entity
Organization
Contact information
Practice address
9 RICHLAND MEDICAL PARK DR, SUITE 340, COLUMBIA, SC 29203-6859
(803) 434-2020
(803) 434-1581
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 434-6836
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA9578
—
SC
05
—
GP6063
—
SC
Enumeration date
12/04/2012
Last updated
09/30/2014
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