Southern Urogynecology Llc
Obstetrics & Gynecology
115 Midlands Ct, West Columbia
South Carolina, 29169-3456
803-732-0738 Southern Urogynecology Llc is a Obstetrics & Gynecology in West Columbia, South Carolina. It is located at 115 Midlands Ct, West Columbia and it's customer support contact number is 803-732-0738. The authorized person of Southern Urogynecology Llc is Dr. Andrea M Pezzella, M.D. who is Owner of this DME and his contact number is 803-732-0738. Active license number of Southern Urogynecology Llc is 29701 for Obstetrics & Gynecology in South Carolina. Southern Urogynecology Llc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Southern Urogynecology Llc is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
DME Supplier Details:
Southern Urogynecology Llc type, location, contact phone number and fax are as below. Patients can directly walkin or can call on the below given customer support phone number for enquiries.
| Name: | Southern Urogynecology Llc |
| Type: | Obstetrics & Gynecology |
| Location: | 115 Midlands Ct, West Columbia,
South Carolina, 29169-3456 |
| Phone: | 803-732-0738 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this supplier is as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Andrea M Pezzella |
| Credentials: | M.D. |
| Position: | Owner |
| Contact Number: | 803-732-0738 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given supplier are as mentioned below.
| NPI Number: | 1952622326 |
| NPI Enumeration Date: | 19 Jun, 2010 |
| NPI Last Update On: | 02 Sep, 2025 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Southern Urogynecology Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Obstetrics & Gynecology | 29701 | South Carolina | Primary | |
| Durable Medical Equipment & Medical Supplies | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of this supplier such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| H19207 | Other | South Carolina | Upin |
Medicare Enrollment:
Southern Urogynecology Llc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 5890989875 | O20101103001064 | Southern Urogynecology Llc | PART B SUPPLIER - CLINIC/GROUP PRACTICE |
| 5890989875 | O20241203000085 | Southern Urogynecology Llc | DME SUPPLIER - PHYSICIAN - UROLOGY |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 115 Midlands Ct,
West Columbia, South Carolina |
| Zip: | 29169-3456 |
| Phone Number: | 803-732-0738 |
Patients can reach Southern Urogynecology Llc at
115 Midlands Ct, West Columbia, South Carolina or can
call on customer care at 803-732-0738.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.