Healthcare Provider Details

I. General information

NPI: 1285667824
Provider Name (Legal Business Name): ANMED HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N FANT ST SUITE C
ANDERSON SC
29621-5702
US

IV. Provider business mailing address

PO BOX 100174
COLUMBIA SC
29202-3174
US

V. Phone/Fax

Practice location:
  • Phone: 864-225-7798
  • Fax: 864-260-3952
Mailing address:
  • Phone: 864-512-3954
  • Fax: 864-125-3952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierGP3165
Identifier TypeMEDICAID
Identifier StateSC
Identifier Issuer

VIII. Authorized Official

Name: STEPHEN JAN GRIGSBY
Title or Position: CFO
Credential:
Phone: 864-512-1109