Provider Demographics
NPI:1164843041
Name:KILGORE GROUP, INC.
Entity Type:Organization
Organization Name:KILGORE GROUP, INC.
Other - Org Name:COLUMBIA HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DISTRICT DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:M
Authorized Official - Last Name:GILCHRIST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-782-2000
Mailing Address - Street 1:435 ELM ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-2643
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4700 FOREST DR
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29206-3119
Practice Address - Country:US
Practice Address - Phone:803-782-2000
Practice Address - Fax:803-743-9428
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STAFFMARK HOLDINGS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-19
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEXG024OtherCLTC PROVIDER #