Organization
COLUMBIA CARDIOLOGY, LLC
Active
Parent organization
COLUMBIA CARDIOLOGY, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLUMBIA CARDIOLOGY, LLC
Authorized official
TRACY B BROWN (BUSINESS OFFICE SUPERVISOR)
(803) 744-2612
Entity
Organization
Contact information
Practice address
1 THE COMMON AT LUGOFF, LUGOFF, SC 29078-8725
(803) 744-4900
(803) 744-2621
Mailing address
PO BOX 4187, COLUMBIA, SC 29240-4187
(803) 744-4900
(803) 744-2621
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CJ9082
RR MEDICARE
SC
05
—
GP3493
—
SC
Enumeration date
01/22/2010
Last updated
11/01/2011
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