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General NPI Number Information
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NPI Number | 1740058551
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Entity Type | Organization
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Legal Business Name | PRISMA HEALTH AMBULATORY SURGERY CENTERS-MIDLANDS, LLC
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Dates
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Enumeration Date | 12/12/2023
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 209 PATEWOOD DR STE 300
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City | GREENVILLE
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State | SC
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Zip | 29615-3592
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Country | US
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Telephone | 864-522-6700
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Fax | 864-522-6705
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Provider Business Mailing Address
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Address Line | 300 E MCBEE AVE FL 4
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City | GREENVILLE
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State | SC
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Zip | 29601-2842
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SVP-FIN, ENTERPRISE PAYOR CONTRACT
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Name | POLLY H MILLER
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Credential |
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Telephone | 864-522-2286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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