| Palmetto Health Coulmbia Crna Services | |
|
3301 Harden St Ext 5 Medical Park Palmetto Health Crna Richland Coulmbia SC 29203-6813 | |
| (803) 296-2548 | |
| (803) 296-2548 |
| Full Name | Palmetto Health Coulmbia Crna Services |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 3301 Harden St Ext 5 Medical Park, Coulmbia, South Carolina |
| Authorized Official Name and Position | Willie P Brown (DIRECTOR OF PATIENT ACCOUNTS) |
| Authorized Official Contact | 8032962342 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Palmetto Health Coulmbia Crna Services Po Box 744244 Atlanta GA 30374-4244 Ph: (803) 296-2548 | Palmetto Health Coulmbia Crna Services 3301 Harden St Ext 5 Medical Park Palmetto Health Crna Richland Coulmbia SC 29203-6813 Ph: (803) 296-2548 |
| NPI Number | 1013041367 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 10/11/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013041367 | NPI | - | NPPES |
| SUFFIX 008 | Other | SC | BCBS CRNA RICHLAND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (South Carolina) | Primary |