Organization Name: | PALMETTO HEALTH |
NPI Number: | 1245461391 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DARRELL C COVEN (DIRECTOR, AMBULATORY SVCS - FINANCE) |
Mailing Address: | 115 Blarney Dr Suite 205 Columbia |
State: | SC US |
Postal Code: | 292236291 |
Phone Number: | 8037366262 |
Fax Number: | 8036991734 |
NPI Enumeration Date: | 08/06/2009 |
NPI Last Update Date: | 04/01/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |