Provider Demographics
NPI:1740293422
Name:UNIVERSITY OF SOUTH CAROLINA
Entity type:Organization
Organization Name:UNIVERSITY OF SOUTH CAROLINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF HEALTH OFFICER & ASSOC. VP
Authorized Official - Prefix:DR
Authorized Official - First Name:STAY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRITZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, PT
Authorized Official - Phone:803-777-3655
Mailing Address - Street 1:1401 DEVINE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29208-0001
Mailing Address - Country:US
Mailing Address - Phone:803-777-3175
Mailing Address - Fax:866-245-2537
Practice Address - Street 1:1401 DEVINE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29208-0001
Practice Address - Country:US
Practice Address - Phone:803-777-3175
Practice Address - Fax:866-245-2537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7492261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health