Providence Pathology Associates Pa

LBN: Providence Pathology Associates Pa
Providence Pathology Associates Pa is an health care organization with primary practice located at 2435 Forest Dr C/O Providence Hospital, Columbia SC 29204-2026. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cytopathology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is the primary health care specialty. Providence Pathology Associates Pa can be contacted via phone (803) 256-5335, or through Modzelewski, Joseph Robert via phone (803) 256-5335.

Contact Information

Primary practice address
2435 Forest Dr C/O Providence Hospital Columbia SC 29204-2026
Phone: (803) 256-5335
Fax: (803) 256-5454
Website:
Map and Directions
Authorized official contact:
Name: Modzelewski, Joseph Robert Doctor of Medicine (MD)
Phone: (803) 256-5335

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cytopathology 207ZC0500X 19654 South Carolina
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 19654 South Carolina

Profile Details

NPI number 1780656363
LBN Legal business name Providence Pathology Associates Pa
DBA Doing business as
Authorized official Modzelewski, Joseph Robert Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 7th, 2006
Last updated Jan 23rd, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780656363 NPPES
South Carolina MEDICAID GP2746

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