Ph Developmental Pediatrics
LBN: Prisma Health University Medical Group
Ph Developmental Pediatrics is an health care organization with primary practice located at 200 Patewood Dr Suite A200, Greenville SC 29615-3593. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, which is considered as the primary health care specialty.
Prisma Health University Medical Group can be contacted via phone (864) 454-5115, or through Lawrence, Kristi Ann via phone (864) 522-8611.
Contact Information
Primary practice address
200 Patewood Dr Suite A200
Greenville SC 29615-3593
Phone: (864) 454-5115
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics | 2080P0006X |
Profile Details
| NPI number | 1578890273 |
|---|---|
| LBN Legal business name | Prisma Health University Medical Group |
| DBA Doing business as | Ph Developmental Pediatrics |
| Authorized official | Lawrence, Kristi Ann |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 17th, 2009 |
| Last updated | Feb 23rd, 2024 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578890273 | NPPES |
| South Carolina | MEDICAID | DRC010 | |
| South Carolina | MEDICAID | DEC300 | |
| South Carolina | Other | 20032744 |
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