Organization
PALMETTO HEALTH
Active
Parent organization
PALMETTO HEALTH
Other names
Lakeview Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
PALMETTO HEALTH
Authorized official
MR. DARRELL C COVEN (DIRECTOR, AMBULATORY SERVICESFINANC)
(803) 296-7301
Entity
Organization
Contact information
Practice address
1316 N LAKE DR, LEXINGTON, SC 29072-7653
(803) 358-1191
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
—
GP5806
—
SC
Enumeration date
10/17/2011
Last updated
08/17/2015
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