Organization
PRISMA HEALTH-UPSTATE
Active
Other names
Prisma Health Primary Care Northlake
Organization subpart
No
Provider details
NPI number
Authorized official
POLLY MILLER (VP-FIN ENTERPRISE PAYOR CONTRACTING)
(864) 522-2286
Entity
Organization
Contact information
Practice address
8 JUSTICE LN, ANDERSON, SC 29621-2354
(864) 760-6130
(864) 760-6125
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/09/2025
Last updated
07/09/2025
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