PALMETTO SURGERY CENTER LLC NPI 1073505038

NPI Information

NPI: 1073505038
Provider Name: PALMETTO SURGERY CENTER LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 42D0969655

Address:
109 BLARNEY DR
COLUMBIA, SC
ZIP 29223
Phone: (803) 865-8200
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PALMETTO SURGERY CENTER LLC is an ambulatory surgical clinic center in Columbia, SC. PALMETTO SURGERY CENTER LLC NPI is 1073505038. The provider is registered as an organization entity type.

The provider's business location address is:

109 BLARNEY DR
COLUMBIA, SC
ZIP 29223-244
Phone: (803) 865-8200
Fax: (803) 419-7910

The provider's authorized official is Alan Brill .
The authorized official title is Managing Owner and has the following contact phone number (803) 865-8200.

The CLIA number assigned to this NPI record is 42D0969655 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/16/2005 and was last updated on 2/12/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	ASF 046	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	ASF 046	OTHER	SOUTH CAROLINA	DHEC LICENSE NUMBER
2	Q322940001	MEDICARE ID-TYPE UNSPECIFIED	SOUTH CAROLINA	MEDICARE PART B PROVIDER
3	ASC 024	MEDICAID	SOUTH CAROLINA
4	42C0001031	MEDICARE ID-TYPE UNSPECIFIED	SOUTH CAROLINA	PROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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