Organization
PALMETTO PRIMARY CARE PHYSICIANS, LLC
Active
Other names
Palmetto Primary Care Physicians-Columbia Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA REEVE (CREDENTIALING COORDINATOR)
(843) 820-3403
Entity
Organization
Contact information
Practice address
7611 SAINT ANDREWS RD, IRMO, SC 29063-2834
(803) 350-9433
(843) 732-2123
Mailing address
PO BOX 530062, ATLANTA, GA 30353-0062
(843) 695-6071
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP9565
—
SC
Enumeration date
10/31/2019
Last updated
11/18/2021
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