Healthcare Provider Details

I. General information

NPI: 1184587784
Provider Name (Legal Business Name): PRISMA HEALTH IMAGING CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PERPETUAL SQ
ANDERSON SC
29621-1713
US

IV. Provider business mailing address

300 E MCBEE AVE FL 4
GREENVILLE SC
29601-2842
US

V. Phone/Fax

Practice location:
  • Phone: 864-522-5130
  • Fax: 864-522-5135
Mailing address:
  • Phone: 864-797-6980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: KRISTI ANN LAWRENCE
Title or Position: DIR-ENROLLMENT & CVO
Credential:
Phone: 864-522-8611