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Organization

PALMETTO HEALTH

Active
Parent organization
PALMETTO HEALTH
Other names
Three Rivers Medical Associates
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
1301 TAYLOR ST, SUITE 8-A, COLUMBIA, SC 29201-2942
(803) 779-1922
(803) 779-6729
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7305
(803) 296-7330

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP5557
SC
Enumeration date
05/14/2010
Last updated
12/23/2010
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