Provider Demographics
NPI:1619788890
Name:PRISMA HEALTH LTACH - BAPTIST
Entity type:Organization
Organization Name:PRISMA HEALTH LTACH - BAPTIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR-ENROLLMENT & CVO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-522-8611
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:803-596-4802
Mailing Address - Fax:
Practice Address - Street 1:7TH FLOOR
Practice Address - Street 2:1330 TAYLOR ST
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:89201-2915
Practice Address - Country:US
Practice Address - Phone:803-296-5010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital