Organization
SISTERS OF CHARITY PROVIDENCE HOSPITALS
Active
Parent organization
SISTERS OF CHARITY HOSPITAL
Other names
Providence Hospital CRNAs
Organization subpart
Yes
Provider details
NPI number
Legal business name
SISTERS OF CHARITY HOSPITAL
Authorized official
JHO R. OUTLAW (EXECUTIVE DIRECTOR)
(803) 454-2600
Entity
Organization
Contact information
Practice address
2435 FOREST DRIVE, COLUMBIA, SC 29204
(803) 454-2613
(803) 765-1732
Mailing address
PO BOX 1467, COLUMBIA, SC 29202
(803) 454-2613
(803) 765-1732
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3278
—
SC
Enumeration date
02/01/2006
Last updated
05/27/2015
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