Organization
PALMETTO HEALTH
Active
Parent organization
PALMETTO HEALTH
Other names
Blythewood Urgent Care
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
738 UNIVERSITY VILLAGE DR, BLYTHEWOOD, SC 29016-7611
(803) 461-0270
(803) 462-0275
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7305
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4843
—
SC
Enumeration date
02/06/2008
Last updated
09/11/2013
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