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Organization

PALMETTO HEALTH

Active
Parent organization
PALMETTO HEALTH
Other names
Columbia Gastroenterology Associates
Organization subpart
Yes

Provider details

NPI number
Legal business name
PALMETTO HEALTH
Authorized official
MR. DARRELL C. COVEN (DIRECTOR-AMBULATORY SERVICES-FINANC)
(803) 296-7301
Entity
Organization

Contact information

Practice address
2739 LAUREL ST, SUITE 1-A, COLUMBIA, SC 29204-2028
(803) 799-4800
(803) 256-0397
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7305
(803) 296-7330

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP5853
SC
Enumeration date
02/01/2012
Last updated
04/10/2012
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