Organization
PALMETTO HEALTH
Active
Parent organization
PALMETTO HEALTH
Other names
Ridge View Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
PALMETTO HEALTH
Authorized official
MR. DARRELL COVEN (DIRECTOR OF BUSINESS DEV., FINANCE)
(803) 296-7301
Entity
Organization
Contact information
Practice address
4311 HARD SCRABBLE RD, COLUMBIA, SC 29229-9422
(803) 296-7313
(803) 296-7330
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 788-6570
(803) 788-6574
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0039
—
SC
Enumeration date
04/18/2007
Last updated
02/11/2009
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