PRISMA HEALTH-UPSTATE - NPI 1336039460 - Clinic/Center in Anderson, SC

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.

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About Prisma Health-upstate NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRISMA HEALTH-UPSTATE (NPI 1336039460), doing business as Prisma Health Primary Care Northlake, is a healthcare organization registered as a rural health in Anderson, South Carolina and active in the NPI registry since July 2025. The organization lists Polly Miller, Vp-fin Enterprise Payor Contracting, as its authorized official.

NPPES Registry Identity

NPI1336039460

Entity TypeOrganization

Primary Taxonomy261QR1300X

Legal Business NamePRISMA HEALTH-UPSTATE

Location Address8 JUSTICE LNAnderson, SC 29621-2354

Mailing Address300 E Mcbee Ave Fl 4Greenville, SC 29601-2842

Phone(864) 760-6130

Fax(864) 760-6125

Organization SubpartNo

Authorized OfficialPolly MillerVp-fin Enterprise Payor Contracting · (864) 522-2286

Enumeration DateJuly 9, 2025

NPPES CertifiedJuly 9, 2025

✔ NPI 1336039460 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities

Taxonomy Code261QR1300X

8 JUSTICE LN, Anderson, SC 29621

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Other Names 1

Doing Business AsPrisma Health Primary Care Northlake