Organization
STATE OF SOUTH CAROLINA
Active
Other names
SC DHEC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENDALL F. QUINTON SR. (DIRECTOR OF RECEIVABLES)
(803) 898-1164
Entity
Organization
Contact information
Practice address
220 MCGEE ROAD, ANDERSON, SC 29625
(864) 260-5541
(864) 260-1014
Mailing address
2600 BULL STREET, COLUMBIA, SC 29201-1708
(803) 898-1164
(803) 898-2262
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000155818
UNISON HEALTH PLAN OF SC
SC
01
—
601231
SELECT HEALTH PROVIDER #
SC
05
—
DHEC04
—
SC
Enumeration date
10/20/2006
Last updated
12/02/2020
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