Organization
PROVIDENCE CARDIOLOGY
Active
Organization
PROVIDENCE CARDIOLOGY
Active
Other names
South Carolina Heart Center
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY ELLIS (CHIEF EXECUTIVE OFFICER)
(803) 254-3278
Entity
Organization
Contact information
Practice address
2351 AUGUSTA HWY, LEXINGTON, SC 29072-2213
(803) 359-2456
(803) 255-2715
Mailing address
2001 LAUREL ST, COLUMBIA, SC 29204-1018
(803) 254-3278
(803) 255-2715
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
SC
Other
Enumeration date
04/03/2013
Last updated
04/03/2013
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