Organization
PALMETTO HEALTH
Active
Parent organization
PALMETTO HEALTH
Other names
Palmetto Health Ophthalmology
Organization subpart
Yes
Provider details
NPI number
Legal business name
PALMETTO HEALTH
Authorized official
MR. DARRELL C COVEN (DIRECTOR-AMBULATORY SRVCS-FINANCE)
(803) 296-7301
Entity
Organization
Contact information
Practice address
9 RICHLAND MEDICAL PARK DR, SUITE 340, COLUMBIA, SC 29203-6859
(803) 434-2020
(803) 434-1581
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 434-6836
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA9578
—
SC
05
—
GP6063
—
SC
Enumeration date
12/04/2012
Last updated
09/30/2014
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