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Contact Information

PROVIDENCE PATHOLOGY ASSOCIATES PA
2435 FOREST DR
C/O PROVIDENCE HOSPITAL
COLUMBIA, SC29204-2026
 Phone: 803-256-5335
 Fax: 803-256-5454
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
 

Cytopathology

207ZC0500X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for PROVIDENCE PATHOLOGY ASSOCIATES PA

NPI Number 1780656363
LBN Legal business name PROVIDENCE PATHOLOGY ASSOCIATES PA
Authorized official JOSEPH MODZELEWSKI - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 02/07/2006
Last updated 01/23/2008 - About 18 years ago
Identifiers
SC License # 19654
SC Medicaid GP2746
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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