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
103 SALUDA RIDGE CT, WEST COLUMBIA, SC 29169
(803) 434-6420
(803) 434-1581
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/23/2018
Last updated
02/08/2021
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