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Organization

PALMETTO HEALTH

Active
Parent organization
PALMETTO HEALTH
Other names
Parkridge Urgent Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
PALMETTO HEALTH
Authorized official
MR. DARRELL C COVEN (DIRECTOR - BUSINESS DEV/FINANCE)
(803) 296-7301
Entity
Organization

Contact information

Practice address
100 PALMETTO HEALTH PKWY, SUITE 104, COLUMBIA, SC 29212-1753
(803) 434-5668
(803) 434-5669
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7305
(803) 296-7330

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
207Q00000X
Family Medicine Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP5000
SC
Enumeration date
06/09/2008
Last updated
06/05/2013
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