Provider Demographics
NPI:1326095324
Name:PRISMA HEALTH-MIDLANDS
Entity Type:Organization
Organization Name:PRISMA HEALTH-MIDLANDS
Other - Org Name:PRISMA HEALTH RICHLAND SPRINGS HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP FINANCE, ENTERPRISE CONTRACTING
Authorized Official - Prefix:
Authorized Official - First Name:POLLY
Authorized Official - Middle Name:H
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-522-2286
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:803-296-2548
Mailing Address - Fax:
Practice Address - Street 1:5 RICHLAND MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6897
Practice Address - Country:US
Practice Address - Phone:803-296-2548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRISMA HEALTH-MIDLANDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-27
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHTL741273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC387175Medicaid
SC400186Medicaid
SC232488Medicaid
SC387175Medicaid