Organization
PALMETTO HEALTH
Active
Parent organization
PALMETTO HEALTH
Other names
ColoRectal Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
PALMETTO HEALTH
Authorized official
DARRELL C COVEN (DIRECTOR, AMBULATORY SVCS - FINANCE)
(803) 296-7301
Entity
Organization
Contact information
Practice address
1333 TAYLOR ST, SUITE 5-F, COLUMBIA, SC 29201-2923
(803) 748-9966
(803) 748-7174
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7305
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP5354
—
SC
Enumeration date
01/14/2010
Last updated
07/03/2015
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