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Organization

STATE OF SOUTH CAROLINA

Active
Other names
Palmetto CRS
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. BETTY H GARREN (DIRECTOR, THIRD PARTY ADMINISTRATIO)
(803) 898-3720
Entity
Organization

Contact information

Practice address
2000 HAMPTON ST, COLUMBIA, SC 29204-1002
(803) 576-2900
Mailing address
1751 CALHOUN ST, COLUMBIA, SC 29201-2606
(803) 898-0288
(803) 898-0501

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000157080
UNISON HEALTH PLAN OF SC
SC
01
20021675
SELECT HEALTH PROVIDER #
SC
05
DHEC50
SC
Enumeration date
12/21/2006
Last updated
05/09/2012
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