Organization
CSC ACQUISITION, LLC
Active
Other names
COLUMBIA SKIN CLINC, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
GRETA ZIMMERMAN D.O, (PARTNER)
(803) 779-7316
Entity
Organization
Contact information
Practice address
1 WELLNESS BLVD STE 109, IRMO, SC 29063-2872
(803) 779-7316
(803) 343-2538
Mailing address
3600 FOREST DR STE 400, COLUMBIA, SC 29204-4057
(803) 779-7316
(803) 343-2538
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7480
MEDICARE PTAN
SC
Enumeration date
05/24/2006
Last updated
07/30/2021
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