MEDICARE: PRISMA HEALTH-MIDLANDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	273R00000X	Psychiatric Hospital Unit	HTL739	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598717316
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRISMA HEALTH-MIDLANDS

Provider Business Mailing Address
First Line	:	300 E MCBEE AVE FL 4
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29601-2842
Country	:	US
Telephone Number	:	803-296-2254
Fax Number	:	803-296-2540

Provider Business Practice Location Address
First Line	:	1330 TAYLOR AT MARION STREET
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-0000
Country	:	US
Telephone Number	:	803-296-2243
Fax Number	:	803-296-2540

Authorized Official
Title or Position	:	VP PAYOR STRATEGIES
Name	:	POLLY H MILLER
Credential	:
Telephone Number	:	864-522-2286

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	02/18/2021

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Directions to “PRISMA HEALTH-MIDLANDS ” Practice Location

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