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NPI Code Detail

MEDICARE: PALMETTO HEALTH

MEDICARE: PALMETTO HEALTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679519144
Entity Type Code : Organization
Provider Name (Legal Business Name) : PALMETTO HEALTH
Provider Business Mailing Address
First Line : PO BOX 402145
Second Line :
City : ATLANTA
State : GA
Zip : 30384-2145
Country : US
Telephone Number : 803-296-7305
Fax Number : 803-296-7330
Provider Business Practice Location Address
First Line : 8 RICHLAND MEDICAL PARK
Second Line : SUITE 400
City : COLUMBIA
State : SC
Zip : 29203-8006
Country : US
Telephone Number : 803-765-0871
Fax Number : 803-765-9215
Authorized Official
Title or Position : DIRECTOR, AMBULATORY SVCS - FINANCE
Name : DARRELL C COVEN
Credential :
Telephone Number : 803-296-7301
Provider Enumeration Date : 06/21/2006
Last Update Date : 09/29/2010

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Directions to “PALMETTO HEALTH ” Practice Location

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