Organization
PROVIDENCE CARDIOLOGY LLC
Active
Organization
PROVIDENCE CARDIOLOGY LLC
Active
Other names
Providence Cardiology
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY R ELLIS (CEO)
(803) 254-3278
Entity
Organization
Contact information
Practice address
114 GATEWAY CORPORATE BLVD, SUITE 300, COLUMBIA, SC 29203-9740
(803) 254-3278
(803) 376-8010
Mailing address
2001 LAUREL ST, COLUMBIA, SC 29204-1018
(803) 254-3278
(803) 376-8010
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
05/19/2014
Last updated
05/19/2014
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