Kaoru Joan Pridgen, M.D., P.A.

LBN: Kaoru Joan Pridgen, M.D., P.A.
Kaoru Joan Pridgen, M.D., P.A. is an health care organization with primary practice located at 11 Gateway Corners Park , Columbia SC 29203-8902. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Kaoru Joan Pridgen, M.D., P.A. can be contacted via phone (803) 462-2335, or through Pridgen, Kaoru Joan via phone (803) 462-2335.

Contact Information

Primary practice address
11 Gateway Corners Park Columbia SC 29203-8902
Phone: (803) 462-2335
Fax: (803) 462-0375
Website:
Map and Directions
Authorized official contact:
Name: Pridgen, Kaoru Joan
Phone: (803) 462-2335

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X 25856 South Carolina

Profile Details

NPI number 1235336082
LBN Legal business name Kaoru Joan Pridgen, M.D., P.A.
DBA Doing business as
Authorized official Pridgen, Kaoru Joan
Entity Organization
Organization subpart 1 No
Enumeration date Jun 27th, 2007
Last updated Aug 29th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235336082 NPPES
South Carolina MEDICAID 258562

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