Organization
PALMETTO HEALTH
Active
Parent organization
PALMETTO HEALTH
Other names
Baptist Vascular Lab
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
TAYLOR AT MARION ST, COLUMBIA, SC 29220-0001
(803) 296-5162
(803) 296-5594
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7305
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4875
—
SC
Enumeration date
03/24/2008
Last updated
09/28/2010
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