Organization
PRISMA HEALTH-UPSTATE
Active
Other names
Prisma Health Pediatrics-Clemson
Organization subpart
No
Provider details
NPI number
Authorized official
POLLY H. MILLER (SVP FINANCE, ENTERPRISE CONTRACTING)
(864) 522-2286
Entity
Organization
Contact information
Practice address
450 OLD GREENVILLE HWY, CLEMSON, SC 29631-1670
(864) 653-8964
(864) 653-8963
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHC235
—
SC
Enumeration date
08/29/2016
Last updated
02/15/2022
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