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General NPI Number Information
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NPI Number | 1407913874
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Entity Type | Organization
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Legal Business Name | STATE OF SOUTH CAROLINA
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 8231 PARKLANE RD
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City | COLUMBIA
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State | SC
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Zip | 29223-4903
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Country | US
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Telephone | 803-896-0801
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Fax | 803-896-0983
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Provider Business Mailing Address
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Address Line | 1751 CALHOUN ST
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City | COLUMBIA
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State | SC
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Zip | 29201-2606
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Country | US
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Telephone | 803-898-0288
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Fax | 803-898-0501
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Authorized Official
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Title or Position | DIRECTOR OF PATIENT BILLING
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Name | ZANNA PERKINS
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Credential |
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Telephone | 803-898-1553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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