Organization
PALMETTO HEALTH
Active
Parent organization
PALMETTO HEALTH
Other names
Ballentine Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
PALMETTO HEALTH
Authorized official
MR. DARRELL C COVEN (DIRECTOR OF AMBULATORY SRVC FINANCE)
(803) 296-7301
Entity
Organization
Contact information
Practice address
1079 DUTCH FORK RD, IRMO, SC 29063-8725
(803) 749-8900
(803) 749-8899
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7303
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
SC
Other
Enumeration date
12/22/2014
Last updated
06/17/2015
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