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NPI Code Detail

MEDICARE: PRISMA HEALTH-UPSTATE

MEDICARE: PRISMA HEALTH-UPSTATE
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
1282N00000XGeneral Acute Care HospitalHTL-0936SC

General Provider Information

NPI Number : 1902352008
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRISMA HEALTH-UPSTATE
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 : 864-455-7000
Fax Number :
Provider Business Practice Location Address
First Line : 2400 BOILING SPRINGS RD
Second Line :
City : BOILING SPRINGS
State : SC
Zip : 29316-5304
Country : US
Telephone Number : 864-699-5700
Fax Number : 864-699-5701
Authorized Official
Title or Position : SVP FIN-ENTERPRISE PAYOR CONTRACTIN
Name : POLLY H. MILLER
Credential :
Telephone Number : 864-522-2286
Provider Enumeration Date : 08/29/2016
Last Update Date : 09/11/2024

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Directions to “PRISMA HEALTH-UPSTATE ” Practice Location

Language Start Address Practice Location
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