Powdersville Medical Park

LBN: Palmetto Health Alliance
Powdersville Medical Park is an health care organization with primary practice located at 15 Roe Road , Greenville SC 29611. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Palmetto Health Alliance can be contacted via phone (864) 295-2308, or through Durham, Kendall J via phone (864) 855-5104.

Contact Information

Primary practice address
15 Roe Road Greenville SC 29611
Phone: (864) 295-2308
Fax: (864) 295-2635
Website:
Map and Directions
Authorized official contact:
Name: Durham, Kendall J
Phone: (864) 855-5104

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1518170182
LBN Legal business name Palmetto Health Alliance
DBA Doing business as Powdersville Medical Park
Authorized official Durham, Kendall J
Entity Organization
Organization subpart 1 No
Enumeration date May 8th, 2007
Last updated Aug 22nd, 2020 - about 6 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 1518170182 NPPES
South Carolina MEDICAID DE1915

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