Provider Demographics
NPI:1710193008
Name:COLUMBIA ARTHRITIS CENTER, PA
Entity Type:Organization
Organization Name:COLUMBIA ARTHRITIS CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:FLINT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-779-0911
Mailing Address - Street 1:1711 SAINT JULIAN PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-2409
Mailing Address - Country:US
Mailing Address - Phone:803-779-0911
Mailing Address - Fax:803-256-2480
Practice Address - Street 1:1711 SAINT JULIAN PL
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2409
Practice Address - Country:US
Practice Address - Phone:803-779-0911
Practice Address - Fax:803-256-2480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTC4107Medicaid
SCTC4107Medicaid