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Organization

PALMETTO HEALTH

Active
Parent organization
PALMETTO HEALTH ALLIANCE
Other names
Carolina Cardiac Surgery
Organization subpart
Yes

Provider details

NPI number
Legal business name
PALMETTO HEALTH ALLIANCE
Authorized official
DARRELL C COVEN (DIRECTOR, AMBULATORY SVCS - FINANCE)
(803) 296-7301
Entity
Organization

Contact information

Practice address
8 RICHLAND MEDICAL PARK, SUITE 400, COLUMBIA, SC 29203-8006
(803) 765-0871
(803) 765-9215
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7305
(803) 296-7330

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PA9883
SC
Enumeration date
06/21/2006
Last updated
09/29/2010
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