Organization
PALMETTO HEALTH
Active
Parent organization
PALMETTO HEALTH
Other names
Northeast Family Practice
Organization subpart
Yes
Provider details
NPI number
Legal business name
PALMETTO HEALTH
Authorized official
MR. DARRELL C COVEN (FINANCE DIRECTOR OF BUSINESS DEV.)
(803) 296-7301
Entity
Organization
Contact information
Practice address
3000 NE MEDICAL PARK, SUITE 209, COLUMBIA, SC 29223-6251
(803) 736-6262
(803) 699-1934
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7313
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0039
—
SC
Enumeration date
06/20/2006
Last updated
12/27/2007
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