Organization
PALMETTO HEALTH
Active
Parent organization
PALMETTO HEALTH
Other names
Parkridge Medical Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
PALMETTO HEALTH
Authorized official
DARRELL C COVEN (DIRECTOR, AMBULATORY SERVICES, FIN.)
(803) 296-7301
Entity
Organization
Contact information
Practice address
100 PALMETTO HEALTH PARKWAY, SUITE 220, COLUMBIA, SC 29212-1755
(803) 749-0693
(803) 749-3986
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7305
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP6103
—
SC
Enumeration date
09/24/2012
Last updated
06/29/2016
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