=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902810971
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PALMETTO HEMATOLOGY ONCOLOGY PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/28/2006
-----------------------------------------------------
Last Update Date | 06/23/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 407 WEST SOUTH STREET
-----------------------------------------------------
City | UNION
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29379-2747
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-427-4993
-----------------------------------------------------
Fax | 864-427-5208
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 407 WEST SOUTH ST
-----------------------------------------------------
City | UNION
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29379-2747
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-427-4993
-----------------------------------------------------
Fax | 864-427-5208
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MD/MANAGING PARTNER
-----------------------------------------------------
Name | COLIN P CURRAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 864-427-4993
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------