Organization
PROVIDENCE HOSPITAL, LLC
Active
Other names
Providence Health
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY J. TEAGUE (ASSISTANT VICE PRESIDENT, SECRETARY)
(615) 920-7000
Entity
Organization
Contact information
Practice address
2435 FOREST DR, COLUMBIA, SC 29204-2026
(803) 256-5300
(803) 256-5935
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
(615) 920-7000
(615) 920-8913
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
ASF058
SC
282N00000X
General Acute Care Hospital
Primary
HTL820
SC
282N00000X
General Acute Care Hospital
HTL821
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274472
—
SC
05
—
429453
—
SC
Enumeration date
06/15/2005
Last updated
03/22/2021
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