Organization
PALMETTO HEALTH
Active
Parent organization
PALMETTO HEALTH
Other names
University Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
PALMETTO HEALTH
Authorized official
MR. DARRELL C. COVEN (DIRECTOR, AMBULATORY SRVC-FINANCE)
(803) 296-7301
Entity
Organization
Contact information
Practice address
4311 HARD SCRABBLE RD, COLUMBIA, SC 29229-9422
(803) 419-6334
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
—
GP5675
—
SC
Enumeration date
04/06/2011
Last updated
08/17/2015
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