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General NPI Number Information
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NPI Number | 1003626326
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Entity Type | Organization
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Legal Business Name | PRISMA HEALTH-UPSTATE
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Dates
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Enumeration Date | 01/09/2025
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 727 SE MAIN ST STE 180
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City | SIMPSONVILLE
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State | SC
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Zip | 29681-3248
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Country | US
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Telephone | 864-455-7000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 402121
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City | ATLANTA
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State | GA
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Zip | 30384-2121
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Country | US
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Telephone | 864-454-9604
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Fax |
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Authorized Official
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Title or Position | DIRECTOR & CVO
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Name | KRISTI ANN LAWRENCE
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Credential |
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Telephone | 864-522-8611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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