Organization
PRISMA HEALTH MEDICAL GROUP-MIDLANDS
Active
Other names
PH Medical Group Midlands
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTI LAWRENCE (DIRECTOR-PROVIDER ENROLLMENT)
(864) 385-4790
Entity
Organization
Contact information
Practice address
100 N SUMTER ST STE 200, SUMTER, SC 29150-4975
(803) 774-7621
(803) 774-1791
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP8575
—
SC
Enumeration date
04/27/2018
Last updated
01/30/2023
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